. ::-■::' : . 



/AATERIA/AEDICA 

F °^ NUF^SES 



<9 




Class J ^W 



Book. 



. 



Copyright^ 



\3o5" 



COPYRIGHT DEPOSIT. 



TEXT- BOOK 

OF 



MATERIA MEDICA 

FOR NURSES 



COMPILED BY 

LAVINIA L. DOCK 

GRADUATE OF BELLEVUE TRAINING SCHOOL FOR NORSES 



FOURTH EDITION, REVISED AND ENLARGED 



G. P. PUTNAM'S SONS 
NEW YORK AND LONDON 

Gbe fsnickerbocker {press 

1905 



■ " 
fMOV 

1 30 39¥- 









Copyright, 1890 

BY 

I,AVINIA I,. DOCK 



Copyright, 1897 

BY 

G. P. PUTNAM'S SONS 



Copyright, 1905 

BY 
G. P. PUTNAM'S SONS 



Set up and electrotyped, Oct., 1890. Reprinted, 1891 ; 1892 (twice) ; 1893 
(twice); 1S94 (three times); 1895 (four times); 1896 (twice); 1897 (twice); 1898 
(three times); 1899 (three times); 1900 (three times); 1901 (twice); 1902 
(twice); 1903 (four times); 1904 (four times); 1905 (twice); Fourth edition set 
up and electrotyped, Oct. , 1905. 



Qfte mnfcfcerbocfeer press, *fflew ffiorft 



PREFACE TO THE FOURTH EDITION. 



The latest revision of the Materia Medica has been 
entirely entrusted to Miss Bean, of the Johns Hopkins 
Hospital Training School for Nurses. As in former 
revisions, synthetic remedies which have borne the test 
of practical experiment have been included, no attempt 
being made to present a full list of these innumerable 
drugs. As in former revisions also, the sources of in- 
formation have been personal rather than from books; 
not taken from other works on Materia Medica but col- 
lected in the pharmacy, the class-room, and the clinic. 
Thus is preserved the practical character which is es- 
sential in the teaching of the nurse. 

Whenever necessary to meet the changes in the 
newest —Eighth Decennial — edition of the United States 
Pharmacopoeia the text of the book has been changed. 
A generous list of new drugs or new preparations of 
drugs will be found either in their proper classification 
or towards the end of the book, and much recent ma- 
terial on alcohol, salts, and other substances has been 
incorporated. Changes in dosage have been made, the 
therapeutic classification recast and improved, and new 
tables added. 

There is given information on serum- and organo- 
therap3^, notes on the hypodermic administration of 
drugs, emetics, and the treatment of poisoning, a list 
of the better-known mineral waters, and an exhaustive 
index which will greatly facilitate the book's use by 
the student. 

Especial thanks for practical help in the revision are 
due to Mr. J. I,. Walz, the pharmacist of the Johns 
Hopkins Hospital. 

iii 



IV PREFACE. 

The author feels impelled by the experience of many- 
years to remind nurses of the subtle dangers of many 
potent remedies with which they are entrusted, and to 
urge upon them most gravely never to lose sight of the 
dreadful possibility of falling under the influence of cer- 
tain drug habits unfortunately but too easily acquired 
in accession to the relief offered by drugs in moments 
of fatigue or of nerve exhaustion. Not to prop her fail- 
ing strength by stimulating drugs is imperative for the 
nurse. It is never necessary to tell a good nurse not 
to prescribe for others — she scorns an act which is not 
only unprofessional, but in the worst possible taste. 

The newest teaching inclines steadily to less and less 
drug giving. Dr. Osier says that the patient who 
takes a medicine must recover twice — once from the dis- 
ease and once from the medicine. The newer teaching 
of nurses, too, must remove the cult of the drug some- 
what farther into the background and make more 
prominent the glorious principles of health preservation 
and reverence for Nature and her laws. 



PREFACE. 

Thk study of materia medica is made, to some 
extent, a part of the course in all our training schools 
for nurses; but, so far, no text-book has been prepared 
along the special lines followed in class recitations. 

Those special lines are well defined, and are limited. 
They begin and end with medicines, and do not run 
into therapeutics. The application of medicine to dis- 
ease is no part of a nurse's study, and there are there- 
fore some inconveniences met with in using — as 
text-books — works on materia medica which are writ- 
ten solely for the use of the medical profession. 

I^arge works, containing all the points which a nurse 
needs to know, contain also an immense amount of 
matter with which she has nothing to do, and are very 
expensive ; while those which are more concise usually 
presuppose a large amount of information, and are, 
indeed, not intended to be used at the beginning of a 
course of study, but rather at the end. 

It is in the hope of filling this middle place that this 
text-book has been compiled, and the attempt made to 
collect from all available sources the scattered points 
which concern a nurse, and to give them simply and 
directly. The outlines followed are those of the classes 
in materia medica as taught in most of our training 
schools for nurses, and include something of the source 
and composition of drugs ; their physiological actions ; 
signs indicating their favorable or unfavorable results ; 
the symptoms of poisons, with their antidotes ; and 
practical points on administration. 

For material I am indebted to the following works: 
"Materia Medica and Therapeutics," by Dr. H. C. 



VI PREFACE. 

Wood; "Quiz Compend of Materia Medica," by Dr. S. 
O. Potter; "Materia Medica and Therapeutics," by 
Dr. R. Bartholow ; ' * lectures on Materia Medica and 
Therapeutics," by Dr. Thomson, edited by Dr. Le 
Fevre; " Manual of Pharmacology, Therapeutics, and 
Materia Medica," by Dr. T. Lauder Brunton; "Materia 
Medica and Therapeutics," by Dr. J. Mitchell Bruce; 
and Dr. Farquharson's " Guide to Therapeutics and 
Materia Medica," edited by Dr. Woodbury. 

I gratefully acknowledge the kind permission ac- 
corded by the authors and publishers of the first five 
works to make extracts from them. For the use of the 
last two I am indebted to the courtesy of Messrs. Lea 
Brothers. Sincere thanks are due also to Dr. Charles 
Rice for much kindness in giving assistance and in- 
formation, and in contributing a table of comparison 
between minims and drops; and to Dr. George Dock 
for revision and corrections and for many practical sug- 
gestions. The classification follows that used by Dr. 
Brunton and Dr. Bruce. The doses are taken mainly 
from Dr. Wood's "Materia Medica and Therapeutics." 



CONTENTS 

PAGE 

Preface to the Fourth Edition iii 

Preeace v 

Introduction i 

The Metric System 16 

classification of remedies 21 

Part I. — The Inorganic Materia Medica: 

The Alkalies and Alkaline Earths .... 35 

The Metals 56 

The Non-Metallic Elements 89 

The Inorganic Acids 104 

The Organic Acids 109 

The Carbon Compounds 118 

Part II.— The Organic Materia Medica : 

The Vegetable Kingdom 161 

The Animal Kingdom 258 

Poisons and their Treatment 265 

Emetics 270 

Hypodermics 273 

Serum Therapy 276 

Radiology . 283 

Mineral Waters 284 

Solution Table 289 

Relation of Minims To Drops 290 

New Drugs 293 

Index 307 



INTRODUCTION. 

Thk broad meaning of medicine {Medicina) is " the 
science and art of healing and curing the sick ' ' (Gould); 
but aside from this meaning the word is used in a re- 
stricted sense, to signify a drug used for the cure or 
relief of disease. The word drug means ' ' a substance, 
simple or compound, natural or prepared, single or 
mixed with other substances, used as a medicine" 
(Gould); and " Materia Medica " covers the entire list 
of such substances, with their whole history. 

On beginning the study of Materia Medica a general 
knowledge should be acquired of the classification of 
drugs considered from three standpoints: 
I. Their source of derivation. 
II. Their physiological actions. 

III. Their ultimate forms and appearance as prepared 
in the pharmacy by definite, standard formulae, for 
administration. 

I. Both the organic and the inorganic worlds furnish 
material useful for medicine, and in the former both 
the animal and the vegetable kingdoms are represented. 
The class of inorganic drugs is large, and comprises 
alkalies, alkaline earths, acids, metals, and non-metals. 
Among them all are many familiar elements, as lead, 
iron, etc. 

The animal kingdom furnishes but a small quota. 
The drugs of vegetable origin are by far . the most 
numerous, and are obtained from green and flowering 
plants, both fresh and dry, fungi, and lichens. The 
whole plant may be represented, or a part only, as the 
flowers, seeds, fruit, stems, or roots. The constituents 
of vegetable drugs are many and varied in character, 
some of them being of great potency. They are ex- 



2 MATERIA MEDICA FOR NURSES. 

tracted from the plant and isolated in a pure form by- 
elaborate chemical processes, and by means of especially 
constructed appliances. 

The principal ones are as follows: aromatic, odor- 
ous, and bitter principles, albuminous bodies, starches 
and sugars, glucosides, oils, gums, resins and oleo- 
resins, and alkaloids. Gums are exudations from the 
stems of plants. Resins are solid, brittle, non-volatile 
substances, insoluble in water; and oleo-resins may be 
broken up into resins and volatile oils. 

The alkaloids are the most important, forming as 
they do a class of poisons of marked characteristics and 
great intensity. They are nitrogenous compounds, 
many of them of deadly power, and are spoken of as 
the " active principles " of those drugs in which they 
are found, and to which they lend their own distinctive 
properties. The name alkaloid is given to them from 
their similarity in many ways to alkalies. 

The other constituents of vegetable drugs are rela- 
tively unimportant. 

II. In considering drugs in reference to the second 
division, we find them grouped according to the effect 
they have on the human organism in disease. This 
mode of classification must be grasped broadly, not by 
rule. It is impossible to assign fixed and definite 
places to all medicines from this standpoint, or to draw 
sharp lines of division. Remembering the complex 
nature of plants, and that one drug may contain more 
than one active alkaloid, and a number of the less im- 
portant substances just named, it is evident that one 
medicine may have several actions; and practically it 
is found that their effects are as scales of varying grada- 
tion, and run insensibly into one another. The same 
drug that in small doses acts as a beneficent agent may 
in large ones be an overwhelming poison; one given 
to quiet the nervous system may also constipate; 
another given for purgation may seriously reduce the 
strength of the heart; another given to strengthen the 
heart may also increase the flow of urine, so that classi- 
fication may well be sometimes a little puzzling. 



INTRODUCTION. 3 

It will dispel bewilderment to remember that the 
most important and prominent characteristic of a drug 
is usually taken as its representative quality, the others 
being for the time ignored. 

Individual peculiarities have much to do in modify- 
ing the physiological actions of drugs. The more 
highly strung nervous organizations respond more 
quickly, as a rule, to the actions of drugs than do those 
of coarser fibre, and more quickly show evidence of 
over-dosing and mild poisoning. Among these tem- 
peraments are found many examples of what is called 
<; idiosyncrasy" — that is, an increased susceptibility to 
the effects of a drug which entirely forbids its use, and 
for which no reason can be discovered. 

Custom makes a decided difference, and the action 
of a medicine is more energetic with one unused to it. 
With frequent repetition comes " toleration," when 
the system accommodates itself to the drug, and larger 
doses can be taken with relatively less effect. Beyond 
this point comes " habit," when the system not only 
tolerates but craves the drug in ever increasing quanti- 
ties, and with the result of a progressive degradation 
of the will power, as is most strikingly shown in the 
ascendency of alcohol and opium over the individual. 

"Accumulation " and " cumulative action " of drugs 
are expressions often met and are self-explanatory up 
to a certain point. While it might be difficult to ex- 
plain the exact processes in the body tissues by which 
drugs are stored up or accumulate in them, it is, fortu- 
nately, sufficient for practical purposes to know that a 
number of drugs do become apparently fixed in the 
tissues, and that niany others accumulate by being 
given more rapidly than they can be excreted. 

Age is an important factor to consider. Strong 
drugs, and especially those that act on the brain, are 
given with much care to children and to the aged. 
The condition of the stomach is another point to con- 
sider. Medicines act more rapidly on an empty 
stomach, and any irritating properties they may have 
are then more marked. Given with or soon after food 



4 MATERIA MEDICA FOR NURSES. 

the action is more gentle and slow. The kinds of food 
taken are to be thought of, and any which might 
neutralize the medicine should be put off for a safe 
interval. In giving medicines to produce sleep, all 
conditions favorable to sleep must first be secured. 
The good effect of many a hypnotic is lost through the 
failure to provide darkness, warmth, and quiet before 
giving it. 

In general the effects of medicines are classed as 
primary and secondary, immediate or remote. By the 
primary or immediate action is meant the first definite 
result of the drug, and subsequent changes which are 
brought about by this first result are termed the second- 
ary or remote effects, viz., if a diuretic is administered 
to a dropsical patient a copious flow of urine soon 
occurs as the primary effect. As a result of increased 
urination fluid is largely abstracted from the body 
tissues, and the consequent diminution of the dropsy 
is the secondary effect. The classes of medicine ac- 
cording to their physiological actions are arranged 
as follows : 

Absorbents. — Those which produce absorption and 
exudation of diseased tissue (Gould). 

Alteratives. — A rather vague term, not universally 
approved, applied to certain drugs which have an un- 
explainable power over the nutritive processes. 

Anaesthetics. — Those which produce a state of in- 
sensibility to pain. They may be (a) general, as ether; 
or (b) local, as cocaine. 

Analeptics. — Restorative medicines, or food. 

Anodynes, Analgesics. — Those which give relief 
from pain. 

Antacids. — Those which counteract acidity. 

Anthelmintics. — Those used to expel (vermifuge) 
or kill (vermicide) intestinal parasites. 

Antiarthritics. — Medicines which relieve gout. 

Antihydropics. — Those which relieve dropsical con- 
ditions. 

Antilithics. — Those which dissolve calculi. 

Antiperiodics. — Those which break up the rhythmi- 



INTRODUCTION. 5 

cal character of some manifestations of disease, as chills 
in ague. 

Antipyretics. — Those which reduce fever. 

Antiseptics. — Medicines which prevent putrefac- 
tion. 

Antispasmodics. — Those which relieve convulsions 
and spasmodic pains (Gould). 

Antizymotics. — Those which have power to kill 
disease germs. 

Aromatics. — Medicines characterized by a spiciness 
of odor and taste, stimulant to the gastro-intestinal 
mucous membrane. 

Astringents. — Those which tend to contract the 
tissues, thus checking secretions. 

Bitters — aromatic. — Those which unite the proper- 
ties of the aromatics and the bitters. 

Bitters— simple. — Medicines which have a bitter 
taste and power of stimulating the gastro-intestinal 
tract without affecting the general system. 

Calefacients. — Those used to produce a sense of 
warmth. 

Cardiac Depressants.— Those which weaken the 
heart's action. 

Cardiac Stimulants. — Those which strengthen the 
heart's action. 

Carminatives are slightly stimulant, and expel gas 
from the stomach and intestines. 

Cathartics, Purgatives. — Those which produce 
evacuation of the bowels. They are subdivided as 
follows : laxatives, or aperients, those of gentle action, 
among which are fruits and some vegetables; drastic 
cathartics, those of severe action causing griping ; 
hydragogue cathartics, those which remove water 
freely from the intestines. Some of the drastics belong 
to this class, and all salines. Saline cathartics produce 
a copious flow of serum from the intestinal walls into 
the canal. The blood serum being of one degree of 
alkalinity and the salts a much stronger solution, an 
active exchange takes place until the two are equalized. 
It was formerly taught that salts should be given in a 



6 MATERIA MEDICA FOR NURSES. 

large quantity of water, but Dr. Hay teaches giving 
them in saturated solution, and states that it is not the 
amount of water in the canal, but in the tissues that is 
of importance, and that purgation may be prevented 
by withholding water from the diet for a day or two. 

Caustics. — Drugs which have the power of destroy- 
ing living tissue. 

Cholagogues. — Those which cause a flow of bile. 

Convulsants. — Those which cause convulsions. 

Correctives. — Medicines used to correct or render 
more pleasant the action of other remedies, especially 
purgatives. 

Demulcents. — Mucilaginous principles which are 
used in solution to soothe and protect irritated mucous 
membranes or other tissues. 

Deodorants. — Substances which destroy or hide 
foul odors. 

Depilatories. — Those used to remove hair. 

Depresso-Motors. — Those which lessen the activ- 
ity of the spinal cord and motor centres (Gould). 

Depurants. — Medicines which stimulate excretions 
and so purify the system. 

Detergents. — Those which cleanse wounds, ulcers, 
etc. 

Diaphoretics. — Those which increase the action of 
the skin and produce perspiration. 

Diluents. — Those which dilute the secretions of 
organs. 

Disinfectants. — Those which have the power of 
destroying disease germs or noxious properties of 
organic matter. 

Diuretics. — Those which increase the flow of urine. 

Ecbolics. — Those which produce abortion. 

Emetics. — Those which produce emesis or vomit- 
ing: (a) local emetics, those that act directly on the 
nerves of the mucous membrane of the stomach, and 
(b) systemic emetics, those that act on the vomiting 
centres in the medulla. 

Emmenagogues. — Those which stimulate the men- 
strual flow. 



IN TR OD UC TION. J 

Emollients. — Substances used to soften and protect 
tissue. 

Epispastics, Escharotics. — Those which produce 
blisters and sloughing. 

Errhines. — Medicines which increase the nasal 
secretion. 

Evacuants. — A term applied to purgatives. 

Excito-Motors. — Those which increase the activity 
of the spinal cord and motor centres (Gould). 

Expectorants. — Those which increase bronchial 
secretions. 

Febrifuges. — Medicines which dissipate fever. 

Galactagogues.— Those which increase the secre- 
tion of milk. 

Haemostatics. — Such as arrest haemorrhage. 

Hypnotics. — Those which produce sleep, but have 
no power over pain. All anodynes are also hypnotics, 
but all hypnotics are not anodynes. 

Mydriatics. — Drugs which cause mydriasis or dila- 
tation of the pupil. 

Myotics. — Those which cause myosis or contraction 
of the pupil. 

Narcotics. — Those which have intensified anodyne 
and hypnotic power, producing a condition of stupor. 

Neurotics. — Those which act on the nervous system. 

Nutriants. — Drugs which modify nutritive pro- 
cesses. 

Nutrients. — Substances which nourish. 

Oxytocics. — Medicines which stimulate uterine 
contractions. 

Prophylactics. — Medicines which prevent the tak- 
ing or development of a disease. 

Refrigerants.— Those which lessen the body tem- 
perature. 

Revulsants. — Those which, by causing irritation, 
serve to draw the blood from a distant diseased part. 
Counter-irritants. 

Rubefacients. — Those which redden the skin by 
distending the capillaries. Rubefacients, epispastics, 
and escharotics must be classified loosely, as many 



8 MATERIA ME DIC A FOR NURSES. 

drugs have all three actions, according to the length 
of time and severity of application. Nitrate of silver is 
an escharotic which does not belong to the other two 
classes. 

Sedatives. — Those which have a soothing effect by 
lowering functional activity (Gould). 

Sialagogues. — Those which produce an increased 
flow of saliva. 

Somnifacients, Soporifics. — Those which cause 
sleep. 

Sorbefacients. — Medicines which cause absorption. 

Specifics. — Those which have direct curative influ- 
ence on certain individual diseases. 

Stimulants. — Those which increase functional 
activity. 

Stomachics. — Stimulants exciting the functional 
activity of the stomach. 

Styptics. — The same as haemostatics. 

Sudorifics. — Those which produce sweating. 

Taeniacides. — Drugs which kill tape-worms. 

Tonics. — Those which promote nutrition and give 
tone to the system. 

Vesicatories. — Blisters. 

III. The preparation of medicines from the crude 
drug is carried on in drug mills and pharmacies by 
many processes of great nicety and by exact formulae 
which place them, when completed, in distinct classes, 
each class differing from all others in one or more 
particulars. To standardize the preparation of drugs, 
each country has its Pharmacopoeia, or authorized pub- 
lication containing the list of such drugs and their 
preparations as are declared official for that country. 
Abroad the national Pharmacopoeias are established by 
law. In this country, representatives of the medical 
and pharmaceutical professions together formulate the 
U. S. P., and appoint a committee to revise it every ten 
years. 

Dispensatories are private unofficial publications — 
commentaries on the Pharmacopoeia, treating with much 
detail not only those official drugs contained in it, but 



INTRODUCTION. 



unofficial ones, and their preparations also. The Dis- 
pensatory and the Pharmacopoeia both give doses. The 
classes of preparations of the U. S. P. are as follows, a 
few being omitted as unimportant: 



UQUID PREPARATIONS. 

Emulsions, Emuha. 
Elixirs, E lixivia. 
Decoctions, Decoda. 
Infusions, Infusa. 
Solutions, Liquores. 
Waters, Aquce. 
Tinctures, Tinctures. 
Fluidextracts, Fluidextracta. 
Spirits, Spiritus. 
Wines, Vina. 
Mixtures, Misturce. 
Vinegars, Aceta. 
Oleates, Oleata. 
Oleoresins, Oleoresince. 
Glycerites, Glycerita. 
Syrups, Syrupi. 
Mucilages, Mucilagines. 
Liniments, Linimenta. 



SOUD PREPARATIONS. 

Extracts, Extracta. 
Resins, Resincz. 
Cerates, Cerata. 
Confections, Confectiones. 
Pills, Pilules. 
Powders, Pulveres. 
Papers, Charta. 
Ointments, Unguenta. 
Plasters, Emplastra. 
Lozenges, Trochisci. 
Suppositories, Suppositoria. 



LIQUID PREPARATIONS. 



Emulsions. — Liquid preparations in which oleagin- 
ous substances are suspended in a minutely divided 
state, by the aid of gummy or viscid substances, in 
water. Six official. 

Elixirs are aromatic sweetened vehicles containing 
alcohol, syrup, and water, with various drugs. They 
are very popular in the United States and are typical 
of the American method of exhibiting drugs. Three 
official. 

Decoctions. — Made by boiling the drug in water. 
A method used for hard fibrous or wood plants. They 
are made in a strength of 5 $ unless otherwise directed. 
None official. 

Infusions. — Made by treating a vegetable drug with 



IO MATERIA MEDIC A FOR NURSES. 

either hot or cold water without boiling. Three offi- 
cial. The strength is the same as that of decoctions. 

Solutions. — Preparations of non-volatile drugs dis- 
solved in water. Twenty-five official. 

Waters. — Solutions of volatile principles dissolved 
in water. Eighteen official. 

Tinctures.— In the Eighth Decennial Revision of the 
Pharmacopoeia, the proportion of drug to the finished 
tincture has been made to conform to the standard 
adopted at the International Conference, Brussels, 1902, 
either ten or twenty per cent, by volume. There are, 
however, exceptions to this general rule. There are 
sixty-four official tinctures. 

Fluidextracts. — Concentrated tinctures or alcoholic 
extracts of definite strength. One Cc. of a fluidex- 
tract represents 1 gramme of the drug; or, 1 minim 
represents 1 grain, approximately. Eighty-five official. 

Spirits. — Solutions of volatile substances in alcohol. 
Twenty official. 

Wines. — Preparations made with a basis of wine. 
Ten official. 

Mixtures. — Watery preparations holding an in- 
soluble substance, finely subdivided, in suspension. 
There are four official mixtures. 

Vinegars. — Preparations made with dilute acetic 
acid. Two official. 

Oleates. — Preparations made with oleic acid. Five 
official. 

Oleoresins. — Preparations containing a mixture 
of natural oils and resins extracted from vegetable sub- 
stances by the action of acetone. They are the most 
concentrated of liquid preparations. Six official. 

Glycerites. — Preparations made with a basis of gly- 
cerin. Six official. 

Syrups. — Preparations made with sugar and water, 
sometimes containing alcohol. Simple syrup is sugar 
and water. Twenty-eight official. 

Mucilages. — Preparations of soluble gummy sub- 
stances dissolved in water. They spoil very quickly. 
Four official. 



INTRODUCTION. II 

Liniments. — Preparations for external application 
with friction. They have an oily or soapy character. 
Eight official. 

SOLID PREPARATIONS. 

Extracts. — Semi-solid or solid preparations, made 
by evaporation of a solution of the soluble substances 
of drugs. Twenty-eight official. 

Resins. — Peculiar substances soluble in alcohol and 
insoluble in water. It is the resinous constituent 
which causes the thick precipitate seen when resinous 
tinctures are diluted with water. Such preparations 
are better diluted with weak wine. Four official. 

Cerates. — Preparations made for inunction with 
white wax. They differ from ointments in that they 
contain a large portion of wax and do not liquefy at 
the body temperature. They are intended for dress- 
ings. Five official. 

Confections. — Medicinal substances prepared with 
a mass of sugar and honey. Two official. 

Pills. — Fourteen official. Need no general descrip- 
tion. 

Powders. — Nine official. Need no general descrip- 
tion. 

Papers. — Papers impregnated with medicinal sub- 
stances. One official, which is for vesication. The 
word " charta " also means the small papers in which 
powders are done up, or, by inference, the powder 
itself. 

Ointments. — Preparations with a basis of vaseline, 
fixed oils, or lard, to be used by inunction. Twenty- 
three official. 

Plasters. — Medicinal substances mixed with lead 
plaster, wax, resin or gum resin, and spread upon 
coarse muslin or white leather, and adherent at the 
body temperature to the skin. Thirteen official. 

Lozenges. — There are nine official. Troches are 
medicated lozenges. 



12 MATERIA MEDICA FOR NURSES. 

Suppositories. — Slender cone-shaped appliances for 
insertion into the rectum, urethra, or vagina. The 
basis is usually cocoa butter. Tt^ should be pro- 
tected against heat and moisture. 

Recent Methods of Exhibiting Drugs. 

Tablets are compressed drugs which are first granu- 
lated, then moistened with alcohol, and rubbed dry 
through a sieve to prevent sticking to the dies of the 
machine. They are prepared in a strictly aseptic way 
and are in much demand because convenient in form 
and easily soluble. 

Collapsubes are collapsible tubes containing oint- 
ments, creams, or lubricants, used with proper attach- 
ments to apply substance to the urethra, uterus, rectum, 
and in ophthalmic surgery. 

Solubes are substances put up in soluble coverings for 
local application as lotions. 

Sterules are glass capsules of sterile solutions for 
ophthalmic and general use. The ends are snipped 
off at the file marks \ in. from each end and the fluid 
is allowed to flow into the part to be treated. 

Vescettes are effervescent salts compressed, and are to 
be used by dissolving in water. 

Cachets consist of little hollowed discs of wafer-sheet, 
so constructed that two can be fastened together by 
their concave surfaces, enclosing a powder. The 
cachet is dipped for an instant in water, when it softens, 
and is placed upon the tongue and carried down by a 
mouthful of water. Large doses of drugs in the form 
of powders may be given in this way. 

Lamella are small gelatin discs containing drugs to 
be inserted between the lower lid and the eyeball. 

Additional Notes. 

We find the metals, as prepared for medicinal use, 
usually in solution, after being changed in form by 
the action of various other chemical agents. Among 



IN TROD UCTION. 1 3 

tinctures, on the other hand, are found many of those 
vegetable drugs from which are obtained the powerful 
alkaloids. But if the pure alkaloids alone are desired, 
as they are insoluble in water and only partly so in 
alcohol, they must be treated as the metals are, and 
combined with an acid to make them ready for inges- 
tion. In this combination both metals and alkaloids 
form what are called " salts " — being perfectly soluble 
in water yet retaining all their medicinal qualities. 
Thus one reads of the " salts " of iron, the " salts " of 
strychnine, etc. Various acids are used, but the most 
common one is sulphuric acid, as it is cheap. These 
salts are then finally prepared for use in solution, and 
distinguished from each other by the name of the acid 
used — e.g., il the solution of the sulphate of morphine," 
the " hydrochloride of cocaine," etc. 

As solutions are made in varying strengths, the face 
of the bottle is always carefully marked either with the 
percentage or with the amount to the drachm. 

A saturated solution is one that cannot be made any 
stronger. The water holds in solution all that it can 
dissolve, and any additional solid material would be 
deposited as a sediment. All saturated solutions are 
not of the same strength, as water dissolves different 
solids in different proportions. Solutions decompose 
very readily. The appearance of a fungus shows when 
decomposition has occurred. 

Many preparations of drugs are injured by age, espe- 
cially when not securely corked. Tinctures and fluid- 
extracts become stronger by reason of evaporation of 
their alcohol. Infusions soon spoil. Many prepara- 
tions are injured by light and air, as the silver solu- 
tions, and others are unstable as to composition. 

Medicinal agents may be applied: (1) to the skin in 
various ways, viz., by inunction, as oils, liniments, and 
ointments, rubbed into the skin; by simple contact 
without rubbing, as medicated baths, cooling or seda- 
tive mixtures, blisters, plasters, powders, etc. ; and by 
painting, as iodine; (2) to mucous membranes, as gar- 
gles, insufflations, sprays, and douches; (3) to wounds 



14 MATERIA MEDIC A FOR NURSES. 

and diseased tissue, as antiseptic powders, ointments, 
and solutions; or they may be administered (4) by in- 
halation, as fumes or vapor; (5) by hypodermic injec- 
tion into the subcutaneous tissues; (6) by the mouth, 
or by the rectum, into the alimentary canal. 

By the first three ways, the effects produced are, 
generally speaking, local (though in many instances 
the local impression may be deepened into a general 
one) and results are slow. 

Inhalation is a rapid mode of impressing the system, 
but only a few drugs are fitted for use in this way. 

Drugs given hypodermically act most promptly, be- 
cause they go directly into the blood current, and are 
diffused through the tissues in a short time. Only 
highly concentrated or powerful agents which are 
active in small bulk can be given in this way; and of 
these, many, otherwise available, are forbidden on 
account of their irritant properties. 

Medicines are most often given by way of the ali- 
mentary canal, and the rectum is used when for any 
reason it is not desirable to use the stomach. 

Having entered the circulation by whatever route, a 
drug is carried by the blood to the tissues, and is finally 
eliminated, or cast off as waste product, by the excre- 
tory organs. 

As the methods of administering medicines, giving 
hypodermic injections, and otherwise applying drugs 
are fully discussed in text-books on nursing, they will 
not be touched on here. The measurements commonly 
used in this country are the minim — Til, the fluid 
drachm — 3 , and the fluid ounce — § , or half ounce 
— I ss. 

The minim is not by any means the exact equivalent 
of a drop, nor are all drops alike. 1 A medicine ordered 
in minims must not be measured by drops, nor one 
ordered in drachms, by a teaspoon. 

It is hardly necessary to say that the nurse should 
always know what she is giving, and in what propor- 

1 Pages 290-292. 



IN TROD UCTION. 1 5 

tions. It is therefore essential that she should learn 
to read prescriptions, to recognize the most important 
ingredient or ingredients contained therein, and to find 
out by arithmetical process the exact amount of such 
ingredients contained in a given dose. 

Dosage. 

In order to facilitate the learning of doses it may be 
advisable to become familiar with the ordinary dose of 
the different classes of drugs. 

Potent tinctures are given in doses of TT[ v. -x v. (0.33- 
1.0 Cc), except the tincture of iodine, which is given 
in doses of ttj, i.-iii. (0.06-0.18 Cc). 

Fluidextracts can be given in doses of fTj, x.-xx. 
(0.65-1.3 Cc). Potent fluidextracts are given in doses 
of TTt i. (0.065 Cc). 

Solid extracts may be administered in gr. i. (0.065 
Gm.) doses. The potent solid extracts are given in 
gr. J (0.016 Gm.) doses. 

Spirits may be given in doses of 3 ss. (2 Cc), except 
the spirits of nitroglycerin v\ i.-iii. (0.06-0.18 Cc), 
and the spirits of phosphorus 1U x. (0.65 Cc). 

Syrups are given in doses of 3 i. (4 Cc); the syrup 
of the iodide of iron in doses of iU x.-xxx. (0.65-2.0 
Cc). 

Diluted acids may be given in doses of TT[ x.-xxx. 
(0.65-2.0 Cc) well diluted and taken through a glass 
tube. Dilute hydrocyanic (prussic) acid is taken in 
doses of TT[ i.-iii. (0.06-0.18 Cc). 

Infusions and decoctions range in dose from one to 
two tablespoonfuls (32-64 Cc). Infusion of digitalis is 
taken in doses of 3 i-iv (4-16 Cc). 



THE METRIC SYSTEM. 

This system of weights and measures, first instituted 
by the French, is now in general use on the Continent 
of Europe, and is legalized in the United States, where 
it is employed in certain departments of the govern- 
ment and by scientific people at large. Many physi- 
cians and surgeons make use of the system, particularly 
in the prescription of medicines and in operating-room 
work. It therefore has become necessary that a nurse 
should understand it, while its simplicity, convenience, 
and accuracy commend the system to everyone. 

The metric tables which most concern a nurse's work 
are as follows : 

Weights. 

i milligramme = o.ooi gramme. 

i centigramme = o.oi 

i decigramme — o.i 

i gramme (Gm ) = i.o 

i decagramme = io.o grammes. 

i hectogramme = ioo.o 

i kilogramme = iooo.o 

Length. 

i millimetre = o.ooi metre, 

i centimetre (cm.) = o.oi 

i decimetre = o.i 

i metre (m.) = i.o 

Volume. 

It is unnecessary here to consider any other measure 
than the cubic centimetre (Cc), which is equal in vol- 
ume to one millilitre. One cubic centimetre of water 
at a temperature of 4 Centigrade weighs one gramme, 
the unit of weight. 

16 



THE 


METRIC SYSTEM. 

Capacity. 




i millilitre = 


o.ooi litre. 




i centilitre = 


O.OI " 




i decilitre = 


O.I 




i litre (1.) = 


I.O 
OR 




i Cc. = 


i Gm. of water. 




10 " = 


IO " " " 




ICO " = 


100 " " " 




IOOO " = 


iooo " " " ^ 


i kilo 



17 



The primary unit of the metric system is the metre, 
(39.37 inches), which is approximately one ten-millionth 
part of the distance from the equator to the north pole; 
and from this as a basis the units of weight and ca- 
pacity are readily derived, the remaining measurements 
in each table being obtained from their units by decimal 
subdivision and multiplication. It will be observed 
that any term less than the unit is expressed by the 
aid of a L,atin prefix (deci, centi, milli), while Greek 
prefixes {deka, hecto, kilo) express multiplication, or 
terms greater. 

To mention the correspondence between the metric 
denominations and those of the United States currency, 
which is a metric currency, may serve to make under- 
standing more clear. It will be noticed that metres — 
for instance — correspond to dollars, decimetres to dimes, 
centimetres to cents, and millimetres to mills. Some- 
what analogous to our method of reading currency is 
that of reading the metric system generally. 

For instance in the figures $5.25 we have represented 
dollars and cents, the latter being equal to -f^ of a dol- 
lar. Similarly in the metric system these figures would 
stand for 5 and T 2 o 5 o of whatever the measure might be 
— whether of length or of capacity. 

Practically, of the table of capacities the litre and its 



1 8 MATERIA MEDIC A FOR NURSES, 

multiplications only are used, as the Cc. is more con- 
venient for small quantities. Frequently, instead of 
the litre, the term iooo Cc. is employed. The cubic 
centimetre (Cc), centimetre (Cm.), and gramme (Gm.) 
are the terms the nurse most often meets with. The 
method of obtaining the gramme, the unit of the 
standard for weighing both solids and liquids, has 
been explained. 

Apothecaries' Weight. 

60 grains = 1 drachm = 3 
8 drachms = 1 ounce =% = 480 gr. 
12 ounces = 1 pound = lb. = 5760 gr. 

Wine Measure. 

60 minims = 1 fluid drachm = 3 
8 fluid drachms = 1 fluid ounce = § 

16 fluid ounces = 1 pint = O. 
8 pints = 1 gallon = gal. 

Common Measure and Metric Equivalents, 

t grain = 0.065 Gm. 

1 ounce Troy = 31.103 " 

1 pound avoirdupois = 453.600 " 

1 fluid drachm = 3.70 Cc. 

1 fluid ounce = 29.57 " 

1 pint = 473. 1 1 " 

1 inch == 2.539 Cm. 

1 gramme = 15-432 grains. 

1 kilo = 2.204 lbs. avoirdupois. 

1 cubic centimetre = 16.23 minims. 

1 litre (1000 Cc.) = 33.81 fluid ounces. 

1 centimetre = Q-393 inch. 

1 metre = 39-37 inches. 



THE METRIC SYSTEM. 1 9 

Approximate Equivalents. 



1 Cc. = 


15 minims. 


4-Cc. = 


1 fluid drachm. 


30 Cc. = 


1 " ounce. 


1 gramme = 


T 5i grains. 


1 decigramme — 


i\ grains. 


1 centigramme = 


i grain. 


1 milligramme = 


eV grain. 


1 litre = 


1 quart. 


1 kilo = 


2\ lbs. avoirdupois. 


1 cm. = 


| inch. 



To obtain the number of grammes, approximately, 
reduce the quantity to grains and divide by 15. Or 

Reduce the quantity to drachms and multiply by 4; 
and proceed on like principles with other denominations. 

It may be interesting to note how often 15 or some 
multiple of 15 comes into use in measuring medicine by 
the metric system or in the ordinary way. Thus, 1 
grain is equal to about 60 milligrammes; 15 grains are 
equal to about 1 gramme; 60 minims are equal to 1 
drachm, or a teaspoonful, or about 4 grammes; 30 
grammes are equal to about 1 ounce; and 15 cubic 
centimetres are equal to about 1 teaspoonful. For one 
who is accustomed to the use of the ordinary measures 
only three of these equivalents will be necessary in 
order to quickly and easily transfer doses from one 
system to the other. These are : 

1 gr. = 60 milligrammes, approximately. 
15 gr. = 1 gramme 
1 1 = 3° grammes 

The following approximate equivalents tnay be used 
(see page 289). 

4 Cc. = 1 fluidrachm = 1 teaspoonful = 60 drops. 

8 Cc. = 2 fluidrachms = 1 dessertspoonful =120 
drops. 

16 Cc. = 4 fluidrachms=i tablespoon ful = 240 drops. 

The abbreviation used for cubic centimetre is Cc, 
and for gramme is Gm. 



Table showing quantities from five grains down, ac- 
cording to the old tables, with their equivalents under 
the metric system: 





Grains 


Grammes. 


in decimal fractions. 


in common fractions 
(approximate). 


0.324 


5 


5 


O.291 


4.5 


4i 


O.259 


4 


4 


O.226 


3.5 


3i 


O.194 


3 


3 


O.162 


2-5 


H 


O.130 


2 


2 


O.097 


i.5 


"* 


O.065 


1 


1 


O.061 


0.94 


if 


O.060 


0.93 


A 


O.057 


0.88 


1 


O.053 


0.82 


tf 


O.05O 


0.77 


i 


O.049 


0.76 


1 


O.045 


0.69 


H 


O.040 


0.62 


it 


O.036 


0.56 


A 


O.032 


0.5 


I 


O.028 


0.43 


fV 


O.025 


0.39 


2 

s 


O.024 


0.37 


3 


0.020 


0.31 


O.OI6 


0.24 


i 


O.OI2 


0.18 


& 


0.008 


0.12 


1 

■g" 


0.004 


0.06 


* 


O.0032 


0.05 


♦ 


0.0027 


0.04 


* 


0.0022 


0.033 


3V 


O.OO18 


0.028 


A 


O.OOI6 


0.025 


A 


O.OO13 


0.02 


A 


O.OOII 


0.017 


A 


O.OOI 


0.015 


£ 


0.0006 


O.OI 


Tiny 


0.0005 


0.008 


1 

ISS 


0.0004 


0.0065 


rks 
■2-^7) 


0.0003 


0.005 


0.0002 


0.003 


3F0 


O.OOOI 


0.0015 


fiTTT 



20 



A CLASSIFICATION OF REMEDIES 

ACCORDING TO THEIR 

PROMINENT THERAPEUTICAL ACTIONS. 

This classification of the Materia Medica, being de- 
signed for the use of nurses, follows the order in which 
Anatomy is commonly taught in training schools for 
nurses, as it is thought that the study of those reme- 
dies most frequently employed in diseases of the various 
systems of the body, taken in conjunction with the 
anatomy and physiology of each system, may induce a 
clearer comprehension of both our Materia Medica and 
Anatomy, and at the same time serve to fix both in the 
mind. 

THE CIRCULATORY SYSTEM. 
Drugs Acting on the Heart 

Cardiac Tonics, — increase force of heart's contraction, 
lessening frequency. 

Strychnine. Digitalis. Arsenic. 
Rest. Graded Exercise. Food. 

Also iron, iodides, mercury, caffeine, adonis vernalis, 
convallaria, fresh air in carriage, cheerfulness, encour- 
agement, Schott baths, cupping, bleeding, purging, 
counter-irritation, douches, etc. 

Cardiac Stimulants, — increase both force and number 
of heart beats. 

Ether. Digitalis. Belladonna. 

Counter-irritation to praecordia. 

Carminatives (Red Pepper. Ginger.) 

Also strophanthus, squills, sparteine, camphor, am- 

21 



22 MATERIA MEDIC A FOR NURSES, 

monia hyoscyamus, stramonium, amyl nitrite, strych- 
nine, chloroform, ammonia to 5th nerve, cold douche, 
flagellation, cupping, leeching, food, air, good diges- 
tion, active liver, cold weather. 

Normal salt solution, one of the most efficient cardiac 
stimulants, has only a mechanical action, supplying a 
fluid of the same specific gravity as the blood, which 
the heart pumps upon until the natural circulation is 
restored. 

Cardiac Sedatives, — lessen force and frequency of pulse. 

Opium. Aconite. Potassium. 
Venesection. Purgatives. 

Also hydrated chloral, veratrine, antimony, dilute 
hydrocyanic acid, ergot, alcohol, chloroform (late 
effect), ipecac, physostigmine, conium, low diet, diu- 
retics, arrest sensory impressions (warm bath), diapho- 
retics, warm weather. 



Drugs Acting on the Vessels. 

Vascular Stimulants, — dilate the vessels through the 
vasomotor centres, equalizing blood pressure. 
Nitroglycerin. Amyl Nitrite. Alcohol. 

Also lobelia, ether, belladonna, liquor ammonii acetatis. 

Local Stimulants (on skin), — dilate the vessels by local 
action. 
Heat (poultices, fomentation). Acrid Oils (mustard). 

Also volatile oils (turpentine, camphor), irritant metals 
(zinc, copper, iron), carbon compounds (creosote, 
phenol, etc.), and pepper. 

Vascular Sedatives. See Hsematinics and Antiphlogis- 
tics. 



A CLASSIFICATION OF REMEDIES. 2$ 

THE RES PI R A TORY SYSTEM. 
Drugs Acting on Respiration. 

Respiratory Stimulants, — stimulate respiration by ac- 
tion on brain centres. 

Strychnine. Ammonia. Atropine. 

Also aconite, belladonna, hyoscyamus, stramonium, 
camphor, caffeine, and cocaine. Alcohol, ether, and 
chloroform in first stages. 

Respiratory Depressants, — lower action of respiratory 
centre. 

Heroine. Hydrated Chloral. Chloroform. 

Also opium, ether, alcohol, antimony, and hydrocyanic 
acid. 

Drugs Acting on the Bronchial Tubes. 

Pulmonary Sedatives, — relieve cough and dyspnoea. 

Heroine. Opium. Hydrocyanic Acid. 

Also codeine, hydrated chloral, bromides, oil of turpen- 
tine, belladonna, hyoscyamus, cannabis indica, chloro- 
form, and wild cherry. 

Expectorants, — modify bronchial secretion and aid its 
expulsion. 

(i) Depressant Expectorants. 

Antimony. Ipecac. Alkalies. 

Also apomorphine, iodides, and general depressants, 
as opium, hydrated chloral, etc. 



24 MATERIA MEDICA FOR NURSES. 

(2) Stimulant Expectorants. 

Ammonium Chloride. Ammonium Carbonate. Squill. 

Also balsam of Peru, balsam of tolu, creosote, senega, 
benzosol, aromatic oils, acids, and syrups. 

Inhalations, — used to stimulate the bronchi, disinfect 
secretions, or relieve spasms. 

Benzoin. Creosote. Amyl Nitrite. 

Also turpentine, oil of eucalyptus, stramonium, conium, 
chloroform, tobacco, nitre paper, steam. 

THE DIGESTIVE SYSTEM. 

Drugs Acting on the Salivary Glands. 

Sialagogues, — increase flow of saliva. 

Pilocarpus. Mercurials. Acids. 

Also tobacco, ether, pungents, iodine, physostigmine, 
antimony, and ipecac. 

Anti-Sialagogues— decrease flow of saliva. 
Atropine. Opium. Alkalies. 

Also belladonna, hyoscyamus, stramonium, tobacco in 
excess, and all nauseous or insipid stuffs. 

Refrigerants ; — allay thirst and create coolness. 

Cool Drinks. Dilute Acids. Cold Externally. 

Also fruit juices, many diaphoretics, and cold per 
rectum or vagina. 

Drugs Acting on the Stomach. 

Emetics, — cause vomiting. 

Stomach Tube. Warm Water. Apomorphine. 
Also mustard, soapsuds, or salt and warm water, tartar 



A CLASSIFICATION OF REMEDIES, 2$ 

emetic, ipecac, zinc or copper sulphate, alum, infusion 
of camomile, and ammonium carbonate. 

Anti- Emetics, — relieve nausea and vomiting. 
Quiet. Morphine. Cerium Oxalate. 

Also bromides, chloral, cocaine, creosote, carbolic acid, 
iodine, lime water, ice, bismuth subnitrate, chloro- 
form, hydrocyanic acid, ipecac (in small doses), and 
alcohol. 

Carminatives, — aid in expulsion of gas from stomach 
and intestines. 

Capsicum. Ginger. Peppermint. 

Also asafoetida, camphor, cardamom, cinnamon, musk, 
cloves, Hoffman's anodyne, spirits of chloroform, dilute 
sulphuric acid, and pungent, spirituous, and aromatic 
stomachics. 

Gastric Tonics or Stomachics \ — excite the functional ac- 
tivity of the stomach, and thus increase appetite and 
aid digestion. 

Nux Vomica. Dilute Acids. All Alkalies. 

Also gentian, quassia, cinchona, calumba, hydrastis, 
eucalyptus, wild cherry, cascarilla, taraxacum, aloes, 
rhubarb, pepsin, pancreatin, and alcohol. 

Gastric Sedatives, — relieve pain and quiet the stomach. 
Bromides. Silver Nitrate. Phenol and Iodine. 



Drugs Acting on the Intestines. 

Cathartics or Purgatives, — hasten intestinal evacuation, 
(i) Laxatives or Aperients, — of moderate action. 
Manna. Cascara. Prunes. 

Also figs, tamarinds, molasses, sulphur, magnesia, 
glycerin, olive oil, and water. 



26 MATERIA MEDICA FOR NURSES. 

(2) Simple Purgatives, — produce active peristalsis 
(and griping pain). 

Castor Oil. Senna. Aloes. 

Also cascara, rhubarb, glycyrrhiza, liquorice, eupato- 
rium, and small doses of drastic, saline, and cholagogue 
purgatives. 

(3) Drastic Purgatives, — intense action ; watery- 
stools ; much pain. 

Elaterium. Croton Oil. Compound Cathartic Pills. 

Also aloes, colocynth, gamboge, jalap, podophyllum, 
and scammony. 

(4) Saline Purgatives or Hydragogues— slight pain ; 
very watery evacuation. 

Epsom Salt. Seidlitz Powder. Rochelle Salt. 

Also sodium sulphate, magnesium citrate, sodium 
phosphate, cream of tartar, and saline waters. 

(5) Cholagogue Purgatives, — remove bile from the in- 

testines. 

Calomel. Podophyllum. Sodium Phosphate. 

Also blue mass, gray powder, iris, euonymus, fel bovis, 
and scammony. 

(6) Intestinal Antiseptics, — destroy low organisms ; 
check fermentation (antizymotics). 

Salol. Naphthalene. Thymol. 

Also beta naphthol, benzosol, silver nitrate, oil of tur- 
pentine. 

Anthelmintics, — destroy {vermicides) or expel {vermi- 
fuges) intestinal worms. 

(1) Tape-worm. 

Filix Mas {B. P.). Cusso. Pepo, 

Also turpentine, thymol, pelletierine, kamala, and gra- 
natum. 



A CLASSIFICATION OF REMEDIES. 2J 

(2) Round-worm. 

Santonin. Spigelia. Senna. 

(3) Thread-worm. 

Quassia. Alum. Sodium Chloride. 

Also tannin, calumba, lime water, and vinegar (by 
enema). 

(4) Hook-worm. 

1. Calomel. 2. Thymol. 3. Epsom Salts. 

THE NERVOUS SYSTEM. 

Drugs Acting on the Spinal Cord and Nerves. 

Spinal Stimulants and Motor- Excitants, — stimulate cells 
of spinal cord; act on motor nerves; increase reflex 
excitability. 

Strychnine. Ammonia. Ether. 

Also picrotoxin (on medulla), ergot, and alcohol. 

Spinal and Motor Depressants, — lower the activity of 
spinal cord and motor apparatus. 

Bromides. Gelsemium. Chloral. 

Also atropine, amyl nitrite, physostigmine, lobelia, to- 
bacco, alcohol, ether and chloroform, cocaine. 

Drugs Acting on the Brain and Nerves. 

Cerebral Stimulants, — increase the activity of the brain, 
most of them producing delirium if taken in large 
doses. Some (as alcohol) are narcotics at last. 
Caffeine. Coca. Camphor, 

Also cannabis indica, guarana, cocaine, belladonna, 
stramonium, hyoscyamus, theobromine, and alcohol. 



28 MATERIA MEDICA FOR NURSES. 

Cerebral Depressants , — lower or suspend the activity of 
the brain. 

(i) Hypnotics or Soporifics, — produce sleep. 

Hydrated Chloral. Bromides. Opium. 

Also paraldehyde, sulphonal, trional, somnal, amylene 
hydrate, hyoscine, exalgine, and urethane. 

(2) Narcotics, — intensified hypnotic power. 
Cannabis Indica. Bromal Hydrate. Chloretone. 
Also opium and other drugs. 

Ancsstheiics, — produce insensibility to pain. 

(1) General Ancsstheiics. 

Ether. Chloroform. Nitrous Oxide. 

Also alcohol, and many derivatives of alcohol and ether, 
Schleich mixtures, ACE mixture, ethyl bromide, 
pental, and bromoform. 

(2) Local Anczsthetics. 

Cocaine. Ethyl Chloride. Eucaine B. 

Also ethyl hydrate, orthoform, carbolic acid, cold, 
sterile water, holocaine, ether. 

Anodynes or Analgesics, — terms applied to drugs that 
relieve mild pain. 

(1) General Anodynes. 

Acetanilide. Opium. Bromides. 

Also phenacetine, antipyrine, all narcotics, and many 
hypnotics. 

(2) Local Anodynes. 

Cold or Heat. Aconite. Menthol. 

Also belladonna, stramonium, carbolic acid, cocaine, 
chloroform and other liniments, chloral, camphor, and 
opium. 



A CLASSIFICATION OF REMEDIES. 29 

Antispasmodics, — prevent or relieve spasm of muscle by 
action on nerve centres. 

Amyl Nitrite. Ether. Bromides. 

Also potassium nitrate, chloroform, chloral, camphor, 
conium, aromatic oils, asafcetida, valerian, alcohol, 
musk, belladonna, stramonium, hyoscyamus, lobelia, 
and opium. 

THE URINARY ORGANS. 

Drugs Acting on the Kidneys. 

Diuretics, — increase the quantity of urine. 

(1) Cardiac, — increase the flow of urine by action 

on heart, and general and local circulation. 

Digitalis. Alcohol. Squills. 
Also strophanthus, spirits of nitre, and convallaria. 

(2) Renal, — increase flow of urine by action on 

kidneys. 

Salines. Buchu. Copaiba. 

Alsocubeb, sandalwood, capsicum, juniper, turpentine, 
cantharides, taraxacum, zea mays, uva ursi, and 
eucalyptus. Salines are potassium acetate, citrate, 
nitrate, and bitartrate, and sodium. 

(3) Combined Cardiac and Renal, — act on heart, 
blood-vessels, and kidneys. 

Caffeine. Diuretin. Water. 

Also theobromine, scoparius, calomel, beer, and gin. 

(4) Urinary Alkalinizers, — render the urine alka- 
line. 

Salts of— 
Potassium. Sodium. Lithium. 

(5) Urinary Acidifiers, — render the urine acid. 

Benzoic Acid. Salicylic Acid. 



30 MATERIA MEDIC A FOR NURSES, 

Drugs Acting on the Bladder. 

Vesical Sedatives or Tonics, — improve the condition of 
the muscle and mucous membrane of bladder and 
urethra, reducing inflammation. 

Copaiba. Salol. Urotropine. 

Also cubeb, buchu, zea mays, eucalpytus, opium, bella- 
donna, hyoscyamus, strychnine, salts of potassium 
and lithium, and local antiseptic and astringent ap- 
plications. 

THE GENERATIVE ORGANS. 

Emmenagogues, — restore or regulate the menstrual 
flow. Most of them are tonic and sedative to the 
uterus and ovaries. 

Viburnum Prunifolium. Iron. Aloetic Purgatives. Savine. 

Also hydrastis, apiol, Pulsatilla, ergot, myrrh, oil of rue, 
tansy. Indirect tonics — strychnine, manganese, cod- 
liver oil, hot hip bath, foot bath. 

Ecbolics or Oxytocics, — cause contraction of the gravid 
uterus or of the uterus following childbirth. 

Ergot. Quinine. Savine. 

Also rue, hydrastis, and cotton-root bark. 

Uterine Depressants, — restrain contraction of the uterus. 

Viburnum Prunifolium. Opium. Chloral. 
Also bromides, chloroform, and cannabis indica. 

Galadogogues, — increase the secretion of milk. 
Pilocarpus. Fluids. Milk. Leaves of Castor Oil Plant. 

Antigalactogogues, — decrease the secretion of milk. 
Belladonna. Camphor, 



A CLASSIFICATION OF REMEDIES. 3 1 

THE SKIN. 

Diaphoretics, — increase the secretion of sweat. In- 
directly they aid the kidneys and reduce temperature. 
Pilocarpine. Dover's Powder. Acetanilide. 

Also salicylates, nitrous ether, antimony, eupatorium, 
potassium, ammonium, camphor, alcohol, heat, antipy- 
rine, asaprol, and other synthetics. 

Anhidrotics, — diminish secretion of sweat. 

Atropine. Hyoscyamus. Picrotoxin. Cold. 

Irritants. — Many drugs when applied to the skin pro- 
duce vascular excitement or irritation; called counter- 
irritants if applied to excite reflex influence at a 
remote point. 

(1) Rubefacients, — cause redness of the skin. 

Mustard. Heat. Turpentine. 

Also ammonia, capsicum, camphor, veratrine, iodine, 
arnica, friction. 

(2) Vesicants or Epispastics, — produce blisters, or 
collection of serum beneath the epidermis. 

Cantharides. Mustard. 

(3) Pustulants, — produce pustules, or small collec- 

tions of white blood corpuscles. 

Croton Oil. Tartar Emetic. 

Caustics or Esckarotics, — destroy the vitality of the 
tissues, producing a slough. 

Nitrate of Silver. Caustic Potash. Sulphuric Acid. 

Also zinc chloride, mercury, copper, chloride of anti- 
mony, bromine, lime, caustic soda ; acids — carbolic, 
nitric, acetic (glacial). 

Astringents, — produce contraction of vessels and tissue 
and lessen secretion from mucous membrane. Known 
as remote or local astringents according as they act 



32 MATERIA MEDICA FOR NURSES. 

on internal organs or affect the part to which they 
are applied. As they chiefly affect the vessels they 
may also be considered in relation to the circulation. 

Tannic Acid. Alum. Iron. 

Also gallic acid ; substances containing tannic acid, as 
galls, hamamelis, catechu, etc.; acetic acid ; salts of — 
lead, silver, zinc, copper, bismuth. 

Antiphlogistics, — agents reducing or subduing inflam- 
mation or fever (Gould). They include all medicines 
and means to this end. 

Styptics or Hemostatics, — arrest haemorrhage. 
Adrenalin. All Astringents. Cold. 

Also ergot, strychnine, digitalis, actual cautery, heat. 

Emollients and Demulcents, — soften and protect skin or 
mucous membranes. 

Vaseline. Cacao Butter. Borax. 

Also olive oil, lanolin, lard, glycerin, starch, lycopo- 
dium, licorice, white of egg, barley water, rice water, 
flax seed, tragacanth, acacia, and other mucilagiuous 
substances. 

Protectives, — used to cover a part. 

Collodion. Guttapercha, etc. 



THE EYE. 

Mydriatics, — cause dilatation of the pupil of the 
eye. 

Atropine. Duboisine. Cocaine. 

Myotics, — contract the pupil. 

Physostigmine (Eserine). Opium, etc. 



A CLASSIFICATION OF REMEDIES. 33 

SUBSTANCES HAVING GENERAL SYS- 
TEMIC EFFECT ON BLOOD AND TISSUE. 

Restoratives, — promote constructional tissue change. 

(1) Foods, — supply new material for repair and 
oxidation. 

Proteids. Carbohydrates. Fats. Salts. Water. 

Including albumins, starches, sugars, sodium chloride, 
calcium phosphate; oils — olive, cod-liver; alcohol and 
other substances. 

(2) H<zmatinics, — increase the haemoglobin (red 
coloring matter) in the blood. 

Iron. Manganese. 

(3) Tonics, — promote nutrition and give tone to the 
system. 

Strychnine. Iron. Arsenic. 

Also quinine, vegetable bitters, phosphates, hypophos- 
phites, cod-liver oil; acids— hydrochloric, nitro-hydro- 
chloric, phosphoric, lactic, citric; salicin, and other 
drugs. 

Alteratives, — by some unknown process alter morbid 
conditions and improve the nutrition of the body. 

Mercury. Arsenic. Iodine. 

Also antimony, gold and sodium chloride, sarsaparilla, 
colchicum, cod-liver oil. 

Antipyretics,— 'reduce fever (1) by promoting loss of 
heat and (2) by lessening its production. 

Cold. Acetanilide. Quinine. 

Also antipyrine, salicylic acid, guaiacol, resorcin, 
phenacetine, aconite, chinoline, asaprol, and others. 

Antiperiodics, — lessen the severity or prevent the return 
of certain periodically recurring diseases. 

Quinine. Hydrastine. Eucalyptus. 
3 



34 MATERIA MED1CA FOR NURSES. 

ANTISEPTICS AND DISINFECTANTS. 

Antiseptics, — arrest the growth of or destroy micro- 
organisms. 

Disinfection, — relates to the complete destruction of the 
organism. 

Formaline. Bichloride of Mercury. Sulphurous Acid. 

Also carbolic acid, boric acid and borax, chloride of 
zinc, oxalic acid, permanganate of potassium, salicylic 
acid, peroxide of hydrogen, oil of eucalyptus, thymol, 
quinine, bismuth, iodoform, europhen, benzoin, lysol, 
aristol, dermatol, pyrogallol, chlorine, naphthalene, 
lime, creolin, and others. 

Deodorants, — remove disagreeable odors. 

Potassium Permanganate. Chloride of Lime. Chlorinated 
Soda. Charcoal, and many others. 

Parasiticides, — destroy parasites on the skin. 

Staphisagria. Picrotoxin. Ichthyol. Mercurials. Sulphur. 
Ether. Alcohol. Carbolic Acid. 



TEXT-BOOK OF MATERIA MEDICA 
FOR NURSES. 



PART I. 

THE INORGANIC MATERIA MKDICA. 

THE ALKALIES AND ALKALINE EARTHS. 

The word " alkali" is formed from two Arabic 
words, " al," meaning " the," and " kali," the name 
of a plant from the ashes of which soda was obtained. 

Chemically, an alkali is one of a class of caustic 
bases, the term "base" being given to the principal 
element of a compound. The chief characteristics of 
an alkali are comparatively well known : it unites with 
oils and fats to form soaps; neutralizes acids and forms 
with them fresh compounds known as salts, which 
possess properties differing from those of either con- 
stituent; turns red litmus paper blue; and is soluble in 
water. 

Those alkalies which are obtained in a solid state, 
viz., soda and potash, are termed " fixed," while am- 
monia, by reason of its gaseous nature, is called a 
"volatile" alkali. 

An alkaloid is an alkaline principle found in the 
tissues of plants or animals, or prepared synthetically in 
the laboratory; more soluble in alcohol than in water, 
and having a definite composition as regards the 

35 



36 MATERIA ME DIC A FOR NURSES, 

proportions of its chemical elements. This composi- 
tion is different from that of an alkali. An alkaloid also 
unites with acids to form salts, and these salts have the 
same physiological and therapeutic actions as the alka- 
loid and are nearly all soluble in water. 

Salt Action or Ion Action. 

The alkalies and their combinations with acids, form- 
ing salts, act in the system in a different way from the 
animal or vegetable drugs or the metals. When the 
salts are taken into the stomach and intestines there is 
set up a process of osmosis, diffusion, and filtration, 
while the secretory activity of the mucous-membrane 
cells in these organs is increased, and, as a result of 
these various actions, water is diverted from the blood 
into the stomach and intestines, at the same time that 
a portion of the salt is absorbed. I^ater the fluid and 
salt are all absorbed in the case of the chlorides, iodides, 
and bromides, this being accomplished readily. The 
carbonates, tartrates, citrates, phosphates, and sul- 
phates are less readily absorbed, the last two being 
very difficult of absorption. The alkalies also vary in 
their rate of absorption, magnesium being very difficult 
of absorption. This enables one to understand why 
magnesium sulphate (Epsom salt) is a good purgative. 

The following list shows the rate of absorption of the 
various alkalies and salts, those most rapidly absorbed 
being given first, the rate decreasing in order as given: 

i Chlorides 



i Ammonium 

2 Sodium 

3 Potassium 

4 Iyithium 

5 Calcium 

6 Magnesium 



2 Carbonates 

3 Citrates 

4 Tartrates 

5 Phosphates 

6 Sulphates 



The action of the saline purgatives is considered to 
take place in this manner: When the salt enters the 
stomach and passes into the intestines, very little if 



THE ALKALIES AND ALKALINE EARTHS. 37 

any of it is absorbed, but a great deal of water is ex- 
tracted from the blood by osmosis, diffusion, and filtra- 
tion. This distends the intestines, increases peristalsis, 
and the contents of the bowel is liquefied and evacuated. 
The blood then repletes itself from the tissues. Should 
the blood and tissues be deficient in fluid this process 
would not go on, and there would be no purgative 
action. The salt would be slowly absorbed and cause 
diuresis, with consequent greater decrease in the fluid 
of the blood. But in cases of dropsy the fluid will be 
drawn off and evacuated through the bowel. The 
saline purgatives should be given in the morning, on 
an empty stomach, in as little water as will dissolve the 
salt, the water being as hot as can be taken internally. 
Activity aids the action of the salines, therefore the 
person taking them should move about during the day 
if practicable. The three alkalies, sodium, potassium, 
and ammonium, with their salts, may be divided into 
four groups. 

I. In this group are placed sodium chloride and 
potassium chloride, which exhibit the specific action 
of the metallic ions, sodium and potassium, and are 
therefore depressant. 

II. Group two contains sodium and potassium 
hydroxide, carbonate, and subcarbonate, which act 
through the non-metallic ion (the hydroxide, carbonate, 
or subcarbonate) by deoxydizing, or drawing oxygen 
from, the tissues. Their action is manifested in three 
ways: They 

1. Neutralize acids, stop stomach secretion, aid pan- 
creatic secretion, and cause alkaline urine. Some claim 
that they stimulate stomach secretion by neutralizing 
acid. 

2. Dissolve proteids, and change them to alkali pro- 
teids — surface effect on skin and mucous membrane. 

3. Saponify fats — surface of body and alimentary 
canal. 

III. Ammonium chloride represents this group. Its 
action is due to both the metallic and non-metallic ion. 
It is stimulant and is used as an expectorant. 



38 MATERIA MEDIC A FOR NURSES. 

IV. Ammonium hydroxide and carbonate belong to 
this group, which is noted for its instability. Am- 
monia is given off freely and readily, exhibiting its 
stimulant effect. "Smelling salts" and aromatic 
spirits of ammonia belong here. 

Salt action is not confined to the alkalies and salts, 
but is possessed by other bodies, such as sugar and 
urea. 

Potassii Hydroxidum (Potassium Hydroxide). 
Potash. 

There are three great natural sources from which 
potash and its salts are derived, viz.: i. Wood ashes. 
2. Argol, the deposit left in wine casks during the fer- 
mentation of grape-juice. 3. Beds of saline earths, 
found chiefly in India, but also to some extent in other 
countries. 

Physiological Actions. 

Potash depresses the muscular, nervous, and cardiac 
tissues. Given long or in concentrated doses it destroys 
muscle and nerve tissue and nerve-centres. 

It is extremely diffusible, and is rapidly excreted, 
principally by the kidneys, but also to some extent by 
the salivary, mammary, and intestinal glands, and by 
the skin. 

In the living organism it is found chiefly in the blood 
corpuscles and muscles. 

Being so quickly removed from the body, the danger 
to the tissues, even from large doses, is comparatively 
slight, except when there is disease of the excretory 
organs, or when it is given for a long time, and under 
these circumstances a dyscrasia or unhealthy condition 
results, characterized by impoverishment and excessive 
fluidity of the blood. 

Symptoms of Poiso7iing. 

In poisoning by the salts of potash there is violent 
inflammation of the alimentary canal; intense burning 



THE ALKALIES AND ALKALINE EARTHS. 39 

pain about the epigastrium; nausea and vomiting, 
sometimes of bloody mucus; and profuse and watery, 
sometimes dysenteric, stools. With these there are the 
symptoms of depression of the general system: a weak, 
rapid pulse; shrunken face; cold skin; coma; and in- 
sensibility. There is sometimes paralysis of the lower 
limbs, and death may occur with great suddenness. 

Trea tment of Po ison ing . 

In potash poisoning dilute vinegar, lemon juice, and 
cider are given as antidotes; the stomach and bowels 
are emptied, and oils, with bland demulcent drinks, 
such as gum tragacanth, barley water, flaxseed tea, 
milk, white of egg, or gruel, given to relieve the irrita- 
tion of the mucous membranes, and stimulants to sus- 
tain the heart. 

Preparations of Potassium Hydroxide. 

Potassii Carbonas. 
Potassium Carbonate. 

A white, granular powder, with strongly alkaline 
taste, which liquefies on exposure to the air by absorb- 
ing moisture from it. Dose, gr. ii.-x. (0.1-0.65 Gm.) 

Potassii Bicarbonas. 
Potassium Bicarbonate. 

Sometimes called saleratus. It is not deliquescent ' 
nor corrosive, nor as irritating as the carbonate; other- 
wise their qualities are the same. They are antacid 
stomachics and mild diuretics; stimulants of the 
liver; expectorants, and have some slight diapho- 
retic action. 

In small doses on an empty stomach they promote 
the formation of gastric juice by increasing the diffusion 
of the blood constituents from which the gastric juice 
is formed. Large doses irritate the stomach, and, taken 
during digestion, decompose the gastric j uice. 

1 Melting by absorbing moisture from the air. 



40 MATERIA MEDICA FOR NURSES. 

These salts are given before or after meals according 
to the effect desired. The alkalinizing action on the 
stomach and kidneys is more pronounced when they 
are taken during digestion. They must be well diluted, 
in mucilaginous or sweetened water. Dose, gr. v.- 3 i. 
(0.3-4. Gm.) 

Liquor Potassii Hydroxidi. 
Solution of Potassium Hydroxide. 

A clear, colorless liquid, strongly alkaline, contain- 
ing about five per cent, potassium hydroxide. Dose 
TTt ii.-xv. ( = gtt. ii.-xv.), well diluted. (0.1-1. Gm.) 

Potassii Hydroxidum. 
Potassium Hydroxide. 
Caustic Potash. 

Grayish- white pencils, hard but very deliquescent. 

Caustic potash is very powerfully corrosive. When 
applied to the skin it melts slowly, destroying the 
tissues by its affinity for moisture and power of dis- 
solving albumin. Its application is very painful and 
great care is required to avoid injury to the surround- 
ing tissues. It differs from nitrate of silver in extending 
its action far below the surface; for this reason it is 
used in cases which require deep- reaching action. The 
healing process takes place more slowly after the ap- 
plication of caustic potash than after that of any other 
escharotic in use. A grayish slough is formed, with 
inflammation of the parts near by. The slough re- 
mains for a time varying from six to twelve days, 
when it separates, leaving a rather indolent ulcerated 
surface. 

In using caustic potash the surrounding tissues 
should be protected by adhesive plaster, having a 
hole cut in it the size of the spot to be cauterized. 
The surface of the plaster is oiled, but the oil must 
not touch the skin. After sufficient action has been 



THE ALKALIES AND ALKALINE EARTHS. 4 1 

obtained, and the plaster removed, the spot may be 
washed with dilute vinegar. 

In cases of poisoning by caustic potash, the corrosive 
action is seen about the lips and fauces in bloody ooz- 
ing, sloughs of mucous membrane, and vomiting of 
shreds of sloughing and bloody tissue. Deformity of 
the mouth and contraction of the oesophagus and of the 
cardiac and pyloric orifices may remain after recovery, 
interfering mechanically with nutrition, and resulting 
in death after periods of time varying from six weeks 
to one or two years. 

Potassii Citras. 
Potassium Citrate. 

Made with citric acid and potassium carbonate. The 
least unpleasant of all the preparations of potash except 
the tartrates. It has diuretic and refrigerant dia- 
phoretic action. In the blood it is decomposed, and is 
excreted by the urine in the form of alkaline carbonate. 
Dose, gr. v.- 3 ss., well diluted. (0.3-2. Gm.) 

Potassii Acetas. 
Potassium Acetate. 

It is antacid, strongly diuretic, and, in large doses, 
mildly cathartic. It increases the flow of urine and 
diminishes the secretion of urea and uric acid. Dose, 
gr. x.-3 i., largely diluted. (0.65-4. Gm.) 

Potassii Chloras. 
Potassium Chlorate. 

The powder is white, odorless, with a cool, salty 
taste. It is not deliquescent. In combination with 
organic matters it is explosive. Soluble in 16 parts of 
cold and 2 \ parts of boiling water. 

Physiological Action. 

Potassium chlorate acts as a stimulant to mucous 



42 MATERIA MEDIC A FOR NURSES. 

membranes and ulcerated surfaces, and its use as an 
application for sore throat is familiar. In medicinal 
doses it has no marked effect upon the system, but 
taken continuously it is very irritating to the kidneys, 
and causes chronic nephritis or inflammation of those 
organs. 

Poisoning by potassium chlorate is manifested in 
three directions: 

i. By the formation of methaemoglobin and the 
destruction of red blood cells. 

2. By irritation of the kidneys. 

3. By depression of the heart. 

Minute quantities of the drug may cause no ill effect, 
but in children, or when more of the drug is taken 
than nature can care for, the formation of methaemo- 
globin by oxidation from the haemoglobin of the red 
blood cells occurs at the same time that the cells are 
destroyed. Extrusion of the haemoglobin from the 
cells is called " laking " the blood. The result of this 
process is that the blood carries less oxygen and the tis- 
sues become asphyxiated by lack of oxygen, the latter 
being held in closer combination in methaemoglobin 
than in haemoglobin. 

The kidne3 7 S are blocked up by the detritus of 
broken-down cells, and there may be acute inflammation 
of these organs — nephritis. 

The depression of the heart and nervous system with 
the body muscles is due to the action of the potassium. 
The drug is especially dangerous for children and 
should not be given to them as a gargle or mouth wash 
in sore throat, diphtheria, etc. 

The poisonous effect of potassium chlorate is not very 
generally known among non-professional people, and 
potassium chlorate is used to excess by numbers of 
persons, without the authority of a physician, under 
the impression that it is perfectly harmless. A nurse 
has many opportunities of observing habits of this kind, 
and should use all her influence to discourage them. 
Potassium chlorate is eliminated unchanged by the 
urine. 



THE ALKALIES AND ALKALINE EARTHS. 43 

Symptoms of Poisoning. 

Taken in sufficient quantities potassium chlorate is a 
powerful poison and has often caused death. The 
symptoms may be acute or subacute. In the former 
case there are violent vomiting, profuse diarrhoea, and 
great dyspnoea and cyanosis. After death, which occurs 
from heart failure, the blood is of a chocolate color. In 
subacute cases there are severe gastro-intestinal symp- 
toms; vomiting of blackish-green matters and swelling 
of the liver and spleen. The urine is albuminous, 
diminished, and sometimes suppressed. Its color is 
dark, reddish brown, or black, and under the micro- 
scope the detritus of red blood corpuscles, which had 
choked the tubules of the kidney, may be seen. The 
nervous symptoms are headache, loss of appetite, great 
pains in the abdomen and other parts of the body, 
marked abdominal tenderness, tonic and clonic muscu- 
lar contractions, a peculiar stiffness of the extremities, 
delirium, and coma. Small ecchymoses sometimes 
appear on the surface of the body, and there is fre- 
quently a general jaundice. In some cases there is a 
fatal relapse after the patient seems in a fair way to 
recover. The smallest poisonous dose is not known, 
but in one case death was caused by a little over J ss. 
A child one year old died from 3 i. given in a night, 
and a child of three years from 3 iii. In one case 
death took place a week after taking § i. 

Dose, gr. x.-xxx., well diluted. (0.65-2. Gm.) 

Potassii Cyanidum. 
Potassium Cyanide. 

It has the odor of hydrocyanic acid and similar 
though somewhat alkaline taste. It is soluble in water. 
When taken into the stomach the acids there convert 
it into hydrocyanic acid. 

Physiological Actions. 

The physiological, therapeutic, and toxic effects of 
this salt are like those of hydrocyanic acid. Death, 



44 MATERIA MEDICA FOR NURSES, 

however, does not occur so soon, and insensibility is 
sometimes not manifested for several minutes. Cases 
of poisoning have occurred from inhalation of the 
vapor; also from absorption through the hands, among 
photographers. There is, usually, little time to employ 
treatment. A weak solution of sulphate of iron has 
the effect of decomposing the poison, and converts it 
into Prussian blue. Cold affusions and other treat- 
ment, the same as used for hydrocyanic-acid poisoning, 
may be tried. Death has been caused by gr. v. 

A solution of potassium cyanide, in the strength of 
2 to 4 grains in § i. of water, will remove the stains 
of nitrate of silver. Dose, gr. to _ tV- (0.006-0.005 G-m.) 

Potassii Bitartras. 
Potassium Bitartrate. 
Cream of Tartar. 

Made from argol, and from lees of wine by purifica- 
tion and evaporation. White crystalline masses of 
pleasant acid taste, not readily soluble in water, requir- 
ing for solution in cold water about 180 parts, or more. 
An active diuretic and hydragogue cathartic. It is 
agreeably given as ' ' cream of tartar lemonade. ' ' The 
quantity ordered is dissolved in hot water, and when 
cool, the clear solution is poured off, flavored with 
lemon juice, and sweetened to taste. In excessive 
doses it will produce gastro-intestinal troubles, and one 
case of poisoning is recorded after taking over 1 ss. 

Potassii Nitras. 
Potassium Nitrate. 
Saltpetre. 

Obtained for medicinal use chiefly by purification of 
native nitre found in beds of saline earths in India. It 
is also found in saltpetre caves in the United States, 
and is manufactured artificially in nitre beds formed 
of animal and vegetable matter, wood ashes, and cal- 
careous earth; and, finally, is obtained from old plaster 
rubbish. 



THE ALKALIES AND ALKALINE EARTHS. 45 

Nitre is refrigerant, diaphoretic, diuretic, and in 
large doses laxative. In excessive or concentrated 
doses it may act as a fatal poison, producing gastro- 
enteritis and derangement of the nervous system. 

Symptoms of Poisoning. 

Burning pain in throat and stomach; bloody stools; 
syncope; collapse and death, sometimes preceded by 
convulsions. Death has been caused by § i„, but when 
in weak solution much larger quantities may be safely 
taken than would cause death if concentrated. There 
is no known antidote. Mucilaginous drinks should be 
given, vomiting freely promoted, and the stomach-pump 
used. 

Dose, gr. ii.-x. (0.1-0.65 Gm.), well diluted with 
barley water or other demulcent. 

Potassii et Sodii Tartras. 
Potassium and Sodium Tartrate. 
Rochelle Salt. 

Made by adding carbonate of soda to a solution of 
potassium bitartrate. A mild saline purgative, less 
efficient but less offensive to the taste than Epsom salt. 
It is given very hot or very cold, in a saturated solu- 
tion. If given in hot water, the addition of tr. ginger, 
gtt. x.-xv., makes it more agreeable to the taste. If 
cold, it may be given in seltzer or carbonated water. 
It should be given early in the day and on an empty 
stomach. 

Dose, 3 ii. (8 Gm.) 

Sodii Hydroxidum. 
Sodium Hydroxide. 
Soda. 

There are four natural sources of the official salts of 
soda and their preparations, viz. : 

1. Sodium, a metallic element. 

2. Sodium chloride, or common salt, obtained from 
sea- water by evaporation and from salt mines. 



46 MATERIA MEDICA FOR NURSES, 

3. Sodium nitrate. Found native in Chili and puri- 
fied by crystallization from water. 

4. Sodium borate or borax; a native product found 
in various localities. 

Physiological Actions. 

The salts of soda are absorbed into the blood and 
excreted from it more slowly than the salts of potash, 
and for this reason the action of soda upon the alimen- 
tary canal is stronger than that of potash. It is 
diuretic, but not as strongly so as potash; antacid) 
and purgative. It is less depressing than potash and 
more easily borne by the stomach. The soda salts are 
taken into the organism in large quantities with food, 
especially vegetables and fruits, and are the chief 
source of the natural alkalinity of the blood. Soda is 
excreted by all the mucous surfaces, by the kidneys, 
the liver, and, possibly, by the skin. 

Sodii Chloridum. 
Sodium Chloride. 
Common Salt. 

Salt performs a very important part in the human 
economy. It exists normally in the blood in the pro- 
portion of 9 to 1000, and is very abundant in various 
normal secretions. Active tissue changes are promoted 
by the presence of salt. It stimulates the desire for 
food, and aids in its thorough alteration and absorp- 
tion. It is the natural antiseptic of the blood; aids 
osmosis, 1 and keeps the fibrin and albumin of the blood 
in solution. Water alone is injurious to cut tissues, 
but a weak solution of salt makes it non-irritant. 
During the course of an inflammation sodium chloride, 
being needed for its solvent action, accumulates in the 
inflamed area, disappearing temporarily from the urine. 
This is notably the case in pneumonia, and the return 
of the chloride to the urine marks a favorable change 

1 The force by which fluids pass through moist membranes. 



THE ALKALIES AND ALKALINE EARTHS. 47 

in the condition of the patient. In substance or in 
strong solution it is irritating to cut surfaces, mucous 
membranes, muscle and nerve tissue. Taken into the 
stomach in large quantities it causes vomiting, and 
when absorbed in excess of the needs of the system it 
causes the nervous irritation which produces the sensa- 
tion of thirst, and which is relieved by taking enough 
water to dissolve the salt and carry it away to be 
excreted by the kidneys. Salt dissolves in 2f parts of 
water. 

In convalescence patients often crave some salty 
article of food which, being indigestible, must be denied 
them, but the need of the system which is thus ex- 
pressed, maybe satisfied by giving salt in another way. 

In feeding babies and young children a pinch of salt 
should always be added to the milk, as its action 
opposes the formation of hard curds in the milk. 

Salt water in strong solution is an anthelmintic. 

Sodii Carbonas. 
Sodium Carbonate. 

Called sal soda, or washing soda. Transparent color- 
less crystals, soluble in two parts of water. Its effects 
are similar to those of the potassium carbonate, but it is 
rarely used medicinally. In large quantities it is an 
irritant poison for which oils and acids are the anti- 
dotes. It is an excellent material for cleaning glass, 
china, and wood. Poured in strong solution into 
drains and water-pipes it carries away grease. It will 
remove the stains made by bichloride of mercury on 
china and glass. 

Sodii Bicarbonas. 
Sodium Bicarbonate. 

Soluble in 12 parts water (saturated solution). 
Sodium bicarbonate has a soothing action in burns, 
eruptions, and irritation of the skin. Dose, as an 
antacid, gr. x.-xx. (0.65-1.3 Gra.) It is pleasantly 
administered in carbonated water — Seltzer or Vichy. 



48 MATERIA MEDICA FOR NURSES. 

Pulvis Effervescens Compositus. 
Compound Effervescing Powder. 
Seidlitz Powder. 

Seidlitz powder is put up in two packets, a white 
paper containing gr. xxv. of tartaric acid (the acid of 
grapes), and a blue one containing gr. xl. of sodium 
bicarbonate and gr. cxx., or 3 ii., of Rochelle salt. 
They are dissolved separately in very cold water, the 
acid in one or two ounces, and the salt -in five or six. 
They are then poured together and taken after the 
first escape of gas, while still effervescing. It is hardly 
necessary to say that they should not be mixed at a 
distance from the patient, but at his side and at the 
precise moment when he is ready to take the dose. 
The glass must be large, to allow for the effervescence, 
and it is well to have a saucer under it, to avoid the 
annoyance of having it effervesce over the top and 
sides. The powders must be kept dry. Exposed to 
the air they become damp and lose their effervescing 
quality. Seidlitz powder is refrigerant and laxative, 
and should be given in the morning on an empty 
stomach. One powder is usually sufficient for a dose, 
acting in from three to six hours. 

Sodii Boras. 
Sodium Borate. 
Borax. 

Borax is found as a native product in several locali- 
ties. It is also artificially made by combining native 
boric acid with soda. On the skin it acts as a soap — 
removing the epidermis. Added to " hard" water, it 
softens it pleasantly for bathing purposes, and is useful 
in many local and external applications by means of 
its cleansing properties. 

Lithium (Lithia). 

I,ithium is obtained from several minerals, and 
traces of it are found in certain mineral waters. 

lithium salts have strong alkaline properties, and 



THE ALKALIES AND ALKALINE EARTHS. 49 

act on the human organism as do the other members 
of the group. It is stated that lithium salts alkalinize 
the urine more decidedly even than salts of potassium. 

Preparations. 

Lithii Carbonas. Lithium Carbonate. Dose, gr. ii.-x. 

(0.1-0.65 Gm.) 
Lithii Citras. Lithium Citrate. Dose, gr. v.-x. (0.3-0.65 Gm.) 
Lithii Benzoas. Lithium Benzoate. Dose, gr. ii.-xv. 

(0.1-1. Gm.) 
Lithii Salicylas. Lithium Salicylate. Dose, gr. v.-xv. 

(0.3-1. Gm.) 

Ammonium (Ammonia). 

Ammonia is a gaseous compound of hydrogen and 
nitrogen; colorless, irrespirable, highly irritant, of 
strong alkaline reaction and pungent odor. It is ob- 
tained in the manufacture of coal gas, and occurs as a 
result of the decay of organic substances. 

Physiological Actions. 

Applied to the skin, ammonia is a powerful irritant, 
causing redness, blistering, and sloughing. Inhaled, 
it causes severe irritation of the air-passages, with 
sneezing, disturbed respirations, flow of water from the 
eyes and nose, and quickened pulse. Ammonia acts 
as a general stimulant to the heart and nervous sys- 
tem, especially the spinal cord and respiratory centre. 
Being rapidly diffused, its action is prompt but some- 
what transitory. It is excreted by the kidneys and 
mucous membranes. 

Symptoms of Poisoning. 

In large amount ammonia is a corrosive poison, 
producing violent abdominal pain, vomiting and purg- 
ing of bloody matters, with convulsions, collapse, and 
death. Consciousness may remain until the last, or 
coma may precede death. In some cases death has 



50 MATERIA MEDICA FOR NURSES. 

taken place within five minutes, having been caused 
probably by oedema of the larynx. The symptoms 
come on at once in poisoning by ammonia. 

Treatment of Poisoning-. 

Dilute vinegar or lemon juice is given to counteract 
the alkali; oils and bland liquids to soothe the mucous 
membrane, which is corroded. Heat favors the action 
of ammonia, and cold antagonizes it; therefore, in 
poisoning by ammonia plenty of cold fresh air should 
be admitted, if possible, and cold applications made 
to the head. The feet must be kept warm. 

Preparations of Ammonia. 

Ammonii Chloridum. 
Ammonium Chloride. 

Made by neutralizing ammoniacal gas liquor with 
hydrochloric acid, evaporating, and purifying. The 
action of ammonium chloride on the skin is soothing 
rather than irritating, as applied in lotions. It has a 
cooling effect, and is a tonic to the sensory nerves, 
and reduces local external inflammation. It has a 
Stimulant action on the liver; is diuretic and diapho- 
retic, and, like other preparations of ammonia, a 
stimulant expectorant. The taste is very nauseous, 
resembling sea-water. 

Dose, gr. v.-xx., well diluted with cold water. 
(0.3-1.3 Gm.) 

Ammonii Carbonas. 
Ammonium Carbonate. 

A very active and quickly diffusible stimulant to 
the heart and respiration, and an expectorant, acting 
in the latter capacity by liquefying the bronchial secre- 
tions, which are thus more easily raised, and the air- 
cells kept free. In large doses (gr. xxx.) ammonium 
carbonate acts as an emetic. It has a nauseous taste, 



THE ALKALIES AND ALKALINE EARTHS, 5 I 

is very pungent, and must be well diluted. It may be 
given in milk. 

Dose, gr. v.-x. (0.3-0.65 Gm.) 

Aqua Ammoniae Fortior. 
Stronger Ammonia Water. 

Has a strength of 28 per cent., and has been used as 
an application to the bites of poisonous animals or ser- 
pents. It may be used as a vesicant, but its action is 
apt to be more severe than is desirable. It acts more 
quickly than cantharides, and does not affect the urinary 
organs. 

Aqua Ammoniae. 
Ammonia Water. 

A solution of the gas in water, 10 per cent, in strength. 
It may be used externally as a counter-irritant. Ap- 
plied in dilute solution to the bites made by insects, it 
relieves the sting. Taken internally, it is a general 
stimulant and antacid. 

Dose, TTt v.-xxv. (nt x. = gtt. x.), largely diluted. 
(0.3-1.6 Cc.) 

Spiritus Ammoniae Aromaticus. 
Aromatic Spirit of Ammonia. 

Contains ammonia water, and 4 per cent, of the car- 
bonate, with oil of nutmeg, of lemon, and of lavender; 
alcohol and water. It is an antacid and stomachic, 
overcoming a feeling of nausea, and a general stimu- 
lant. It is not unpleasant. 

Dose, 3 ss.- 3 i. ( ttj, x. = gtt. xxv.), well diluted in 
milk or water. (2-4 Cc.) 

Liquor Ammonii Acetatis. 
Solution of Ammonium Acetate. 
Spirit of Mindererus. 

Made from carbonate of ammonia and dilute acetic 
acid. It is more active than the other preparations, as 



52 MATERIA MEDIC A FOR NURSES. 

a diaphoretic, especially if the body be kept warm. 
If the skin be kept cool, its diuretic action is more 
pronounced. It is also a nervous stimulant. Dose, 
3 i.-3 iv., well diluted with water. (4-16 Cc.) 

Linimentum Ammoniae. 
Ammonia Liniment. 

A mixture of ammonia water with alcohol and cotton- 
seed oil. It should be freshly made. 

Raspail's Sedative Water. 

A mixture of ammonia water, sodium chloride, and 
camphorated spirits of wine, with water. For sponge 
baths; cooling and sedative. 

Nitrous Oxide Gas (Laughing Gas). 

Nitrous oxide gas is a colorless, inodorous gas that 
can be liquefied by pressure, and is made by heating 
ammonium nitrate to 350-450 F., and washing the gas. 
It is used in dentistry, in minor surgery, and as a 
starter in ether and chloroform anaesthesia. It is ad- 
ministered through an inhaler connected with a cylin- 
der, where the gas is under pressure, and is given 
without admixture with air. The inhalation is carried 
on until distinct cyanosis is visible. Unconsciousness 
comes on in from one-half to three minutes. Anaes- 
thesia occurs when the blood becomes dark. Blood 
pressure is very high and there is almost complete 
asphyxia. Return to consciousness occurs in from one 
to three minutes after removal of the gas, without 
leaving any after-effects except a slight headache, 
which may persist for hours. Nitrous oxide is the 
safest known anaesthetic, and much the most pleasant. 

Calcium Oxide (Lime). 

Calcium occurs abundantly in nature and in manu- 
facture. It is found largely as a carbonate in the form 
of limestone, chalk, marble, etc.; as a sulphate as 



THE ALKALIES AND ALKALINE EARTHS. 53 

plaster of Paris, gypsurn, alabaster; as a phosphate in 
the different phosphate rocks and bone ash. Calcium is 
an exceedingly important constituent of the body, 
being found, in the form of solution of the phosphate, 
in every animal tissue and fluid. It gives solidity to 
bones, and accumulates wherever rapid tissue changes 
are taking place. The preparations of calcium are 
antacid and slightly astringent. Locally they are 
sedative to mucous membrane. Calcium is a valuable 
antidote in poisoning by oxalic acid, chloride of zinc, 
and the mineral acids. It can always be obtained for 
this purpose in the form of wall-plaster or whitewash. 

Preparations of Calcium Oxide. 

Calx. 

Lime. 

Made from chalk or limestone by calcining (purifying 
and rendering friable by the action of heat). In this 
state it has the form of compact white masses, which 
readily absorb water, crack, evolve heat, and fall into 
powder. It is then called slaked lime, or quick-lime. 
If it should come in contact with the eye, it should be 
washed out with a solution of boric acid. 

Liquor Calcis. 
Lime-Water. 

Lime-water is a saturated solution of lime containing 
about f of a grain to § i. of water. It is made by 
washing slaked lime and shaking it up in distilled 
water, preferably, though ordinary water may be used. 
After it settles, the water is poured off from the sedi- 
ment and strained. It is colorless, inodorous, and 
has a disagreeable alkaline taste. By exposure to the 
air it absorbs carbonic acid, and should therefore 
always be kept well corked. Lime-water acts as a 
gastric sedative, and added to milk prevents its 
curdling in large lumps. The ordinary proportion is 
lime-water J ss. to milk | v., increased, according to 



54 MATERIA MEDICA FOR NURSES. 

circumstances, to \ or even \ lime-water. Lime-water 
is slightly constipating. 

Milk of Lime. Whitewash. 

To one part of slaked lime, as above, four parts of 
water are added. This, mixed thoroughly with in- 
fectious stools, and added until the mixture gives a 
strong alkaline reaction when tested with litmus paper, 
is considered an efficient disinfectant for cholera and 
typhoid stools. Next to it in value comes chloride 
of lime, which is not effective unless fresh. This is to 
be made in a solution of six ounces to one gallon of 
water. 

Syrupus Calcis. 
Syrup of Lime. 

Five parts of lime to one hundred parts syrup. Dose, 
31. (4Cc.) 

Linimentum Calcis. 
Lime Liniment. 
Carron Oil. 

A mixture of lime-water and olive oil or linseed oil, 
in equal parts, for external use. It is an excellent ap- 
plication for burns, and has the merit of cheapness. 

Creta Praeparata. 
Prepared Chalk. 

Made from chalk by a cleansing and drying process. 
A smooth white powder, insoluble in water, and of 
astringent action. Externally, it is used as a dusting- 
powder. When taken internally it may be administered 
in glycerin or syrup. Dose, gr. v.- 3 i. (o-3~4- Gm.) 

Mistura Cretae. 
Chalk Mixture. 

Contains prepared chalk gr. xxx. to § i., and is an 
astringent. Dose, 3 i.- 3 ss. (4-16 Cc.) 






THE ALKALIES AND ALKALINE EARTHS. 55 

Calcii Chloridum. 
Calcium Chloride. 

A white salt, very deliquescent, and soluble in water. 
Used to increase the coagulability of the blood, as in 
typhoid fever and aneurism. Dose gr. v.-xv. (0.3-1. 
Gm.) 

Magnesii Oxidum (Magnesium Oxide) 
Magnesia. 

The official preparations of magnesia are all derived, 
directly or indirectly, from the sulphate. 

Physiological Actions. 

Magnesia, in the form of the oxide and carbonates, 
forms insoluble and comparatively harmless compounds 
with the mineral acids. It is therefore used as an anti- 
dote for these poisons, the oxide being preferable, and 
to be very freely given. 

Magnesia has antacid, purgative, and diuretic 
qualities. Entering the circulation, it increases the 
alkalinity of the plasma, and is partly excreted by the 
kidneys, rendering the urine more abundant and less 
acid. 

Preparations of Magnesia. 

Magnesii Sulphas. 
Magnesium Sulphate. 
Epsom Salt. 

Made from dolomite, or magnesian limestone, by 
solution in sulphuric acid and purification. A quickly 
acting hydragogue cathartic, easily borne by the 
stomach, though of nauseous taste. Ordinary laxative 
doses act in a few hours. Large doses ( 3 i.-ii.) produce 
a result almost immediately, and cause griping and 
abdominal distension. It should be given well diluted 
and on an empty stomach. It is soluble in 2\ parts of 
water. Dose, 3 ss. (16 Gm.) in carbonated, Seltzer, 
or Vichy water. 



56 MATERIA MEDIC A FOR NURSES. 

Liquor Magnesii Citratis. 
Solution of Magnesium Citrate. 

In small doses a laxative, in large ones cathartic, 
acting in from four to six hours. It is effervescent, 
and should be kept cold and taken at the moment it is 
poured out. If the whole amount is not taken at once 
the bottle should be stood on the corked end or laid on 
its side. Dose, § vi.-xii. (180-360 Cc.) 

Magnesii Sulphas Effervescens. 
Effervescent Magnesium Sulphate. 

A white coarse-grained salt of refreshing taste, very- 
soluble and effervescent, acting in the same way as the 
liquor. 

Dose, 3 i.-iv. stirred up in cold water. (4-16 Gm.) 

Cerium (Cerium). 

A metal of which the oxalate only is used. 

Cerii Oxalas. 
Cerium Oxalate. 

A white granular powder, insoluble in water, alcohol, 
or ether. It is a gastric sedative, and is given dry 
on the tongue. Dose, gr. i.-v. (0.06-0.3 Gm.) 

THE METALS. 

Plumbum (Lead). 

L,ead is found native in small masses. It is a dull, 
whitish metal with a tint of blue, and is not given in its 
native state, medicinally, but in the form of salts. 

Physiological Actions. 

The special property of the lead salts is astringency, 
and they are, in consequence, sedative, anti-phlogis- 
tic, and haemostatic. 



THE METALS, 57 

Used in dilute solutions externally as applications to 
ulcers, mucous surfaces, etc., they precipitate the albu- 
minous fluids which cover the surface, contract the 
small blood-vessels, and harden the tissues of the young 
growing cells. Applied in concentrated solutions, 
they are irritant, causing inflammation, or increas- 
ing it. Taken internally, their action is first evident 
as a peculiar astringent taste, with a dry feeling of the 
throat. In the stomach and intestines the same action 
is shown. Lead dries the secretions, contracts the 
vessels, and checks peristaltic action, thus causing 
constipation. 

It is changed by the intestinal juices into an albumi- 
nate, and so enters the blood. It is rapidly deposited 
in the tissues, especially in the central nervous system, 
the kidneys, liver, and bones. It is excreted, but 
slowly, in the bile, the urine, and perspiration; also by 
the mammary glands. It diminishes the excretion of 
uric acid by the kidneys. 

Poisoning by Lead. 

Acute lead poisoning is rare, and will be spoken of 
in connection with the acetate. Chronic poisoning is 
quite common, the poison being introduced into the 
system in one or more of the following ways: By ab- 
sorption through the unbroken skin, as in the case of 
painters, glaziers, etc. — the fine particles of metal which 
are rubbed off and adhere to the skin being changed by 
its secretions into soluble salts which are readily ab- 
sorbed; by absorption through ulcers, wounds, etc., 
from the excessive application of ointments; by the use 
of food put up in cans soldered with lead, cooking 
utensils made of painted wood or imperfectly burnt 
pottery, and by eating buns, cake, etc., colored with 
chromate of lead; by the habit of biting silk thread 
adulterated with lead; by sleeping or working in 
newly painted rooms, and by the poisoning of a water 
supply from lead pipes. This does not occur with 
11 hard " water — viz., that containing salts of lime, as an 



58 MATERIA MEDIC A FOR NURSES, 

insoluble coating is then deposited on the lining of the 
pipes; but with pure, or "soft" water, the lead is 
slowly dissolved in the form of a carbonate. The first 
symptoms of poisoning are: A feeling of pain, with a 
sense of sinking in the region of the navel; loss of ap- 
petite, thirst, and dryness of the mouth and throat, 
with a metallic astringent taste; pale face and skin 
generally; fetor of the breath; constipation; emaciation 
and wasting of the muscles, especially those of the 
arms; swelling of the joints, and rheumatic pains. 
Colic is a very pronounced symptom, sometimes com- 
ing on very suddenly, sometimes after several days' 
illness. The pain is intense and varies in character, 
sometimes being sharp, sometimes dull, or, again, 
11 twisting," and seems to centre about the umbilicus. 
This fact of its being localized differentiates it from 
hepatic colic, which goes through to the back, and 
from renal colic, which radiates along the line of the 
ureters. The abdominal walls are violently retracted 
and rigid, and neuralgic pains seize the abdominal 
muscles and shoot along those of the thorax and ex- 
tremities, especially the flexors. The skin and con- 
junctivae sometimes become jaundiced, and the urine 
tinged with bile. 

A very striking feature of lead poisoning, occurring 
both in acute and chronic cases, is the dark slate- 
colored line on the gums along the margin of the in- 
cisor teeth. It is said to be more marked in those 
cases where the tooth-brush is not used. 

The chronic nervous symptoms of lead poisoning 
may be developed after the first attack of colic, or they 
may come on without marked abdominal disturbance. 
The most common and noticeable one is the paralysis 
of the extensor muscles of the forearms, causing what 
is termed " wrist-drop." With this there is sometimes 
either partial or complete anaesthesia of the affected 
members. 

Paralysis of the laryngeal muscles sometimes occurs, 
resulting in aphonia. The pulse is incompressible and 
tense, full, and infrequent. There may be anaesthesia 



THE METALS. 59 

of the optic nerve as a result of the direct action 
of lead, or dimness of sight may result from the albu- 
minuria which is often present; and, finally, there 
may be a condition of cerebral disturbance known as 
" encephalopathia saturnina," or lead encephalopathy, 
beginning with headache, and characterized by de- 
lirium, stupor, epileptiform convulsions, and coma. 
Death may follow, although severe cases have been 
known to recover. Death may also result from the 
gradual failure of nutrition, or from an extension of 
paralysis to the muscles of respiration. 

Treatment of Poisoning. 

In treating chronic lead poisoning, large doses of 
purgatives are given. Potassium iodide aids in elimi- 
nation of the poison, and baths of potassium sulphide 
are also used for this purpose. Workers in lead may 
guard against poisoning by personal cleanliness, which 
is of great importance, by the use of sulphuric- acid 
lemonade, and milk, as a food, in large quantities. 

Preparations of Lead. 

Plumbi Acetas. 
Lead Acetate. 
Sugar of Lead. 

Made by the action of acetic acid on litharge, or 
lead oxide. This is the only preparation of lead given 
internally. Acute poisoning has been caused by the 
lead acetate, although, as it acts as an emetic, it is 
rarely fatal. The symptoms appear in from half an 
hour to two hours after taking it, and are essentially 
the same as described under chronic poisoning. Re- 
covery may take place within a few days, although 
symptoms recur, occasionally, after a long interval. 
The fatal dose is between f i. and 3 ii. The treatment 
consists of large doses of Glauber's and Epsom salts; 
castor oil; emetics, if vomiting is not already excited; 
opium; and albuminous drinks freely given. 

Dose, gr. ss.-ii., always in pill. 



60 MATERIA MEDICA FOR NURSES. 

Liquor Plumbi Subacetatis. 
Solution of Lead Subacetate. 
Goulard's Extract. 

Used only externally. It should be diluted, in a 
strength of 1 i.-iv. to O. i. of water. 

Ceratum Plumbi Subacetatis. 
Cerate of Lead Subacetate. 
Goulard's Cerate. 

Compound of wool fat, paraffin, white petrolatum, 
camphor, and Goulard's extract. For external use. 

Emplastrum Plumbi. 
Lead Plaster. 
Diachylon Plaster. 

Made with soap, lead acetate, and water. 

Emplastrum Adhaesivum. 
Adhesive Plaster. 

Made of rubber, lead plaster, and petrolatum. 

Emplastrum Saponis. 
Soap Plaster. 

Made of soap, lead plaster, and water. 

Unguentum Diachylon. 
Diachylon Ointment. 

Made of lead plaster, olive oil, and oil of lavender. 

Argentum (Silver). 

The metal silver itself is not used in medicine, and 
its preparations are not numerous. The properties of 
silver will be described under its most important salt. 

Argenti Nitras. 
Silver Nitrate. 

Prepared by dissolving silver in nitric acid. 



THE METALS. 6 1 

Physiological Actions. 

Silver nitrate has locally a caustic, or corrosive 
action. It combines with the albumin of the tissues, 
forming a superficial slough. It has a strong metallic 
and styptic taste, and in the stomach produces a feeling 
of warmth. It is decomposed by the gastric juice, and, 
therefore, does not act as an irritant to the stomach, 
unless taken in poisonous doses. Silver enters the 
blood as an albuminate, and, if continued for some 
time, a part of it remains permanently in the connective 
tissues, staining them a dull slate-gray, which cannot 
be removed. This tinge first appears as a line along 
the gums and teeth, and on the mucous membrane in- 
side the lips and cheeks. In small doses silver is 
astringent and anti-spasmodic, stimulates secre- 
tion and nutritive processes, and is a nerve tonic. 
Iyong continued it disorders digestion, and produces a 
general waste of tissue, albuminuria, rapid and irregu- 
lar heart action, disturbed respiration, and nervous 
symptoms, viz. : tetanic convulsions, loss of the power 
of co-ordination, and paralysis. 

Symptoms of Poisoning. 

Iu toxic doses silver causes gastro-enteritis, and the 
antidote is common salt, given very freely in solution. 
It forms an insoluble chloride, and also acts as an 
emetic. 

Preparations of Silver. 

Dose of the nitrate, gr. \-\ (0.015-0.03 Gm.), in pill, 
given after meals, unless otherwise ordered. Silver 
nitrate is quickly decomposed, if in solution, by organic 
matter and by the action of light, and is for that rea- 
son kept in dark-colored bottles, and should never be 
left uncorked. With tannin it forms an explosive 
compound. 



62 MATERIA MEDIC A FOR NURSES. 

Argenti Nitras Fusus. 
Silver Nitrate. 
Lunar Caustic. 

Made by evaporating silver nitrate and forming it 
in pencil-shaped moulds. It is used externally as a 
caustic. It is not deliquescent; its action is superficial 
and does not extend beyond the point touched; and the 
slough formed is rapidly healed. In applying silver 
nitrate the pencil should always be washed in an anti- 
septic solution before and after using, and, especially 
before it is put away, carefully dried. 

Argenti Nitras Mitigatus. 
Mitigated Silver Nitrate. 
Mitigated Caustic. 

Made with silver nitrate and potassium nitrate. For 
local use externally, and is used as an application to 
the eyelids. 

Aurum (Gold). 
Preparations of Gold. 

Auri et Sodii Chloridum. 
Gold and Sodium Chloride. 

This salt is a somewhat deliquescent powder of salty 
metallic taste, soluble in water. The precise physio- 
logical action of the salts of gold are not well under- 
stood. Clinically the gold preparations are looked 
upon as alteratives and nerve tonics, improving general 
nutrition, and more especially the nutrition of the ner- 
vous system. The most prominent use of gold is in 
connection with the alcohol habit. It is believed that 
in the Keeley Institutes for the cure of alcoholism the 
treatment consists in part at least of the gold and 
sodium chloride, with intervening doses of strychnine 
and atropine. 

The dose in solution or pill form is gr. j\ - i- 
(0.006-0.02 Gm.) Hypodermically it is irritating and 
painful. 



THE METALS. 63 

Auri Chloridum. 
Gold Chloride. 

It is claimed that this salt is useful in lupus and other 
tubercular diseases. Dose, gr. T £ 7 . (0.00043 Gm.) 

Auri et Potassii Bromidum, 
Gold and Potassium Bromide. 

This drug is used in the treatment of epileptic condi- 
tions. It is usually given hypodermically. Unpleas- 
ant symptoms referable to the cardiac region may be 
caused by it, as pain and rigor, but they do not last 
long. Dose, gr. \-\. (0.02-0.04 Gm.) 

Zincum (Zinc). 

There are two sources of the salts and preparations 
of zinc, viz.: the metal, zinc, and the native carbonate, 
calamine. 

Physiological Actions. 

The salts of zinc are, in their stronger forms, caustic ; 
in weaker forms, astringent and antiphlogistic. 
The activity of the different preparations is in propor- 
tion to their solubility and difiusibility. Applied to a 
broken surface or mucous membrane, the salts of zinc 
harden the albuminous secretions, check the growth of 
new cells, and contract the vessels, though in a lesser 
degree than do lead and silver. The salts of zinc, in 
the blood, take the form of albuminates. They enter 
the circulation slowly, do not have the tendency to 
accumulate and remain fixed in the tissues as do lead, 
mercury, and copper, and are much more rapidly ex- 
creted. They are eliminated by the liver, kidneys, 
intestinal and mammary glands. 

Symptoms of Poisoning. 

If the use of zinc be long continued there may result 
a series of symptoms similar to those of lead-poisoning, 
though less severe — viz., wasting of the tissues and 



64 MATERIA MEDICA FOR NURSES. 

loss of strength; pallor; muscular weakness and trem- 
bling; colic; fetid breath ; constipation; feeble mind; 
and paralysis. 

Treatme7it of Poisoning. 

In cases of acute poisoning by zinc salts the antidotes 
are lime-water, tannin, in the form of strong tea, car- 
bonate of sodium or potassium, soap-suds, and muci- 
laginous drinks, milk, etc. Vomiting should be 
encouraged and, if necessary, the stomach washed out. 

Preparations of Zinc. 

Zinci Chloridum. 

Zinc Chloride. • 

Made by dissolving zinc which has been melted and 
poured into cold water, in dilute hydrochloric acid, and 
boiling. It then goes through several purifying pro- 
cesses. A whitish-gray, deliquescent substance, soft, 
like wax, and with very corrosive and irritant action. 
It is used as a caustic and acts powerfully, causing 
destruction of the part, with severe pain, followed by 
sloughing which heals slowly. An impure solution 
known as Burnett's fluid, containing 200 grains to \ i. 
of water, is sold as a disinfectant and has caused numer- 
ous cases of poisoning. The symptoms, which are 
those of severe gastro-enteritis and collapse, come on 
immediately, and death may result in a few hours, or 
be delayed for several days. 

Zinci Sulphas. 1 
Zinc Sulphate. 

Made by dissolving zinc in dilute sulphuric acid, and 
crystallizing. Soluble in water. In small doses sulphate 

1 Zinc solution for the disinfection of white clothing. Sul- 
phate of zinc, 1 ii. Common salt, § iv. Water, 1 gallon. 
Soak clothes for from 4 to 6 hours, boil, and wash. 



THE METALS. 6$ 

of zinc has tonic and astringent properties. Con- 
tinued long in medicinal doses it may cause ulcera- 
tion of the mucous membrane of the alimentary canal. 
Zinc sulphate is a specific emetic. It acts promptly, 
and entirely by its local irritant action, not being 
absorbed, and causing no flow of secretions. It is not 
constitutionally depressing, and causes but little nausea 
either before or after the act of vomiting. 

Dose (medicinal), gr. T V~i- (0.006-0.06 Gm.) 
Dose (emetic), gr. xv.^xx. (1.-1.3 Gm.), largely di- 
luted with warm water, and given every fifteen minutes 
until vomiting occurs. 

Zinci Oxidum. 
Oxide of Zinc. 

A yellowish white powder, insoluble in water, and 
used principally to dust over the skin as an astringent. 
Sometimes used as an astringent internally. 

Dose, gr. ss.-v. (0.03-0.3 Gm.) 

Unguentum Zinci Oxidi. 
Zinc Ointment. 

Made of oxide of zinc, usually twenty parts, to ben- 
zoinated lard, eighty parts. 

Cuprum (Copper). 

The action of copper is very similar to that of silver 
and zinc. Metallic copper is inert. The salts are not 
absorbed by the unbroken skin, but applied to mucous 
membranes and exposed tissues they are caustic, 
stimulant, and astringent. Internally in small doses 
they have the last two, and also tonic, qualities; and 
in large doses act on the stomach as irritants, causing 
vomiting, and on the intestines as irritant purga- 
tives. Copper salts enter the blood vety slowly, 
and are eliminated by the saliva, bile, faeces, and 
urine. 
5 



66 MATERIA MEDICA FOR NURSES. 

Preparations of Copper. 

Cupri Sulphas. 
Cupric Sulphate. 
Copper Sulphate. 

Sometimes called blue vitriol, or bluestone. 
Externally it is used as an escharotic, and internally 
as a tonic and astringent. 

Symptoms of Poisoning. 

In cases of acute poisoning by blue vitriol, as much 
as | ss. or upwards will produce the following symp- 
toms, which come on in a few minutes: A strong 
metallic taste in the mouth; nausea, and vomiting of 
bluish or greenish liquids; a feeling of constriction in 
the throat; a distended abdomen; colicky pains in the 
stomach and bowels; diarrhoea and tenesmus. These 
symptoms are fully developed in one or two hours. 
Then follow rapid and difficult breathing; small, quick 
pulse; great thirst; cold perspiration; weakness, giddi- 
ness, stupor, coma, convulsions, and paralysis. Death 
may occur in a few hours, or be delayed several days. 

Treatment of Poisoning. 

Albumin, as white of egg, milk, wheat flour, should 
be given, and then, as the albuminate of copper is not 
entirely harmless, the stomach should be well washed 
out with plenty of warm water. Stomach-pump used 
if necessary. The chemical antidote is potassium ferro- 
cyanide, but with this, too, emesis should follow 
promptly. 

Dose (medicinal), gr. T V~i. (0.004-0.015 Gm.) 
Dose (emetic), gr. iii.-vi. (0.15-0.3 Gm.) 
Copper poisoning, acute and chronic, may result from 
the use of dirty copper dishes and cooking utensils, 
and from cooking acid fruits in copper. Chronic 
poisoning is also caused by the inhalation of the fumes 
of copper, as in certain occupations, and by the adul- 
teration of certain articles of food, as pickles, which 



THE METALS. 6j 

are sometimes colored green with copper. Chronic 
poisoning presents the same symptoms as the acute 
form, but in a lesser degree, and death may result from 
exhaustion. 

Alumen (Alum). 

Alum is the sulphate of aluminum and potash and 
has a crystalline form and a taste which is both acid 
and sweetish, and also astringent. It is soluble in 
water, but insoluble in alcohol. 

Physiological Actions. 

Alum is an astringent and styptic. In doses of 
3 i. it is an irritant but non-depressing emetic, and in 
large doses a purgative. Taken into the mouth, the 
flow of saliva is first increased by alum, and afterwards 
diminished, as it hardens the albumin of the secretions 
and contracts the capillaries. 

The same effect is shown on the mucous membrane 
of the stomach. Alum is absorbed into the blood, not- 
withstanding its power of coagulating albumin, and 
checks capillary haemorrhage by constricting the 
vessels. Alum should always be given alone, and 
it is to be remembered that it has a very injurious 
action on the teeth. 

Symptoms of Poisoning. 

In large doses alum produces gastro-enteritis, with 
frothing at the mouth. The treatment consists in pro- 
moting vomiting and washing out the stomach, giving 
magnesium hydrate in large quantities, or a weak 
solution of ammonium carbonate at intervals. Death 
has been caused in eight hours in an adult by § ii. of 
alum. 

Preparations of Alum. 

Alumini Sulphas, 
Aluminum Sulphate. 

Should be given diluted and with a glass tube. 
Dose, gr. x.-xx. (0.65-1.3 Gm.) 



68 MATERIA MEDIC A FOR NURSES. 

Alumen Exsiccatum. 
Dried Alum. 

Alum which has been deprived of its water by heat, 
and powdered. Combined with alcohol (in which it 
is insoluble), in the proportion of 3 i.-iv. to alcohol 
1 v.-vi., it is used to harden the skin, as a preventive 
of bed-sores. 



Ferrum (Iron). 

All the salts and preparations of iron are made 
directly or indirectly from the metal. 

Physiological Actions. 

Iron is the most important of the mineral tonics, and 
may be more properly described as a food rather than 
as a medicine, being one of the most essential constitu- 
ents of the red blood corpuscles. It exists normally in 
the blood in the proportion of i part iron to 230 parts 
red corpuscles, and in a state of health enough iron is 
taken with various kinds of food, to supply the demand. 
Beef especially, as an article of diet, provides iron, as 
it contains 1 part iron to 194 parts red corpuscles. 

Iron has been called the great respiratory food. In 
the lungs it takes up oxygen from the inspired air, and 
carries it to all the tissues. No function of the body 
can be carried on without oxygen; the muscular system 
especially is dependent for its perfect activity on the 
presence of oxygen, and muscular power is in direct 
proportion to the efficiency of the respirations. 

The feeling of tone and energy, both bodily and 
mental, which belongs to perfect health, comes from an 
ample supply of oxygen, and it is in this primary way 
that iron acts as a tonic ; stimulates and strengthens 
the heart, nerves, and muscles; raises the tem- 
perature of the body and increases the appetite. 

It is not absorbed by the unbroken skin, but on 



THE METALS. 69 

exposed tissue and mucous surfaces its action is astrin- 
gent, coagulating the albumin of tissue and plasma, 
diminishing the circulation by compression of the ves- 
sels, and arresting hemorrhage. Iron is thus classed 
as a styptic or haemostatic. 

Taken internally there is an astringent taste, and the 
tongue and teeth are darkened by a sulphide which is 
deposited as a result of decomposition. If given in 
excess or on an empty stomach it decomposes the 
digestive fluid, and acts as an irritant and astringent 
upon the mucous membrane. 

The digestion or absorption of iron takes place partly 
in the stomach and partly in the intestines, and depends 
upon the presence, in normal quantities, of the gastric 
and intestinal juices. 

Organic and inorganic compounds of iron are be- 
lieved to be absorbed with equal readiness in the 
alimentary canal, principally in the duodenum, whence 
they pass to the spleen, where they are stored 
up, being given off to the blood later, and carried to 
the liver, where they assist in forming haemoglobin. 
Some part of the iron is afterwards taken into the 
blood, and is excreted by the caecum and large intestine. 
This is the prevalent view regarding the absorption of 
iron and its distribution throughout the system. Some 
claim that the inorganic iron combines with the sulphur 
in the intestines, forming the sulphide of iron which is 
excreted in the faeces, thus leaving all the food iron to 
be absorbed. Part of the food iron would be taken into 
combination, otherwise, by the sulphur, preventing 
absorption. 

Iron has sometimes an irritant action on the bladder; 
its astringency in the alimentary canal causes constipa- 
tion; and it is said that it decreases the secretion of 
milk in nursing women. An excess of iron is elimi- 
nated from the system in almost every possible way, 
but principally by the faeces, which it colors black by 
forming a sulphide. 

The local irritant action of iron explains why it is 
always given well diluted and after meals. 



70 MATERIA MEDIC A FOR NURSES. 

Incidental Effects. 

In administering a course of iron, two things must 
be provided for : 

i. The bowels must be loose. 

2. The digestion must be good ; and in the course of 
administration any one or more of the following symp- 
toms may be noticed, indicating an excess in the system: 
frontal headache, slight disturbances of the digestion, 
irritation of the stomach or of the bladder, a feeling of 
weight at the epigastrium, constipation, a feverish con- 
dition. An acne of the face and chest is sometimes 
produced by iron, and the reduced iron causes eructa- 
tions of gas. 

It is very important to remember that all preparations 
of iron stain clothing, carpets,— in fact everything 
touched, and that the stains are with difficulty removed. 
Silver spoons should never be used for iron, but if they 
have been used, the stain will come off if rubbed with 
ammonia water undiluted. Oxalic acid will take the 
stains out of muslin or linen. 

Preparations of Iron. 

The five preparations of iron which are especially 
recommended because of their effectiveness and because 
they are the least irritating of the iron compounds are: 

Tincture of the chloride. 

Syrup of the iodide. 

Solution of the acetate of iron and ammonia (" Bas- 
ham's Mixture"). 

Pills of the carbonate (" Blaud's Pills"). 

Iron and potassium tartrate. 

{Saline Combinations.} 
Tinctura Ferri Chloridi. 
Tincture of Ferric Chloride. 

Sometimes called the muriated tincture. 
It is reddish-yellow in color, and has peculiar prop- 
erties. It is the most frequently used of all the 



THE METALS. 7 1 

preparations of iron. It is astringent, irritating, 
and somewhat corrosive. It has diuretic and anti- 
spasmodic qualities, owing probably to the ether, and 
is antiseptic by virtue of the chlorine and iron; tonic, 
as are all iron preparations. It contains about 4$ of 
metallic iron. 

T r. of iron should never be given at the same time 
with tea, or with other medicines containing tannin, 
as an ink-like combination results. It should not be 
added to whiskey, but may be well given in milk, being 
dropped in at the moment when it is to be taken. It 
may be given with glycerin, 3 parts to iron 1 part, the 
glycerin to prevent constipation, or it may be dropped 
into egg albumen to prevent its action on the teeth. It 
is a very incompatible drug, and should not be given 
at the same time that another drug is administered. 
Iron attacks the teeth, unless properly diluted, and 
should always be given through a glass tube. When 
the throat is gargled with iron, the teeth should be 
brushed after each application, or washed off with salt 
water. 

Dose, TT[ ii.-xv. (TT[ x. = gtt. xxv.) (0.1-1. Cc), half 
an hour after meals, in a tumblerful of water. 

Liquor Ferri et Ammoniae Acetatis. 
Solution of Acetate of Iron and Ammonia. 
Basham's Mixture. 

Composed of tr. of ferric chloride, dilute acetic acid, 
solution of ammonium acetate, elixir of orange, 
glycerin, and water. It should be freshty made. 

Dose, 3 ss.-i., well diluted. (16-32 Cc.) 

Syrupus Ferri Iodidi. 
Syrup of Ferrous Iodide. 

Iodide of iron affects the teeth seriously. It has 
iodine, iron, and syrup, and exerts a special action on 
nutrition by means of the iodine. 

Dose, TT[ v.-xx. (tt[ x. = gtt. xiii.), largely diluted. 
(0.3-1.2 Cc.) 



72 MATERIA MEDICA FOR NURSES. 

Mistura Ferri Composita. 
Compound Iron Mixture. 
Griffith's Mixture. 

Contains ferrous sulphate, potassium carbonate, and 
myrrh. 

Dose, | ss.-i. (16-32 Cc.) 

Liquor Ferri Subsulphatis. 

Monsel's Solution. 

Solution of Ferric Subsulphate. 

Contains about 13 <f of metallic iron. 

Ferrous sulphate, sulphuric and nitric acids are con- 
stituents of Monsel's solution. It has a deep red color 
and the consistency of syrup. It is an active styptic, 
but it is rather uncertain in its action, sometimes caus- 
ing severe sloughing, and is not much used. 

Liquor Ferri Tersulphatis. 
Solution of Ferric Sulphate. 

Contains about 10 <f metallic iron. The chief employ- 
ment of it is in making other ferruginous preparations. 
It should always be kept on hand for the quick prepara- 
tion of the antidote to arsenic. * 

Pilulae Ferri Carbonatis. 
Pills of Ferrous Carbonate. 
Blaud's Pills. 

Contains sulphate of iron and carbonate of potassium, 
althaea, tragacanth, and glycerin. Dose, pit. i. 

Ferrum Reductum. 
Reduced Iron. 
Quevenne's Iron. 

A light gray powder, quite tasteless, and of all the 
preparations of iron the most free from astringency. 
Dose, i.-ii. gr. (0.05-0.1 Gm.), taken after meals in pill 
form. It may be given to children in candy or lozenges. 



THE METALS. 73 

Pilulae Ferri Iodidi. 
Pills of Ferrous Iodide. 

Contain reduced iron, iodine, glycyrrhiza, acacia, and 
balsam of tolu. 

Ferri et Potassii Tartras. 
Iron and Potassium Tartrate. 

Thin, transparent, garnet-red scales, very soluble 
in water and containing about 15 % of iron. It is to 
be recommended because it is perfectly non-irritating 
and because it contains potassium which, in conjunc- 
tion with iron, has a specific, salutary effect on the red 
blood corpuscles. Dose, gr. v.-x. (0.3-0.6 Gm.) 

Pilulae Aloes et Ferri. 
Pills of Aloes and Iron. 

Contain ferrous sulphate, aloes, aromatic powder, 
and confection of rose. Used as a tonic and laxative. 
The astringent effect of the iron is counteracted by the 
aloes. Dose, gr. iv.-viii. (0.2-0.5 Gm.) 

(A?itidotes to Arsenic.) 

Ferri Hydroxidum. 
Ferric Hydroxide. 

As an antidote to arsenic this preparation of iron 
must be fresh, and may be quickly prepared by adding 
to several ounces of the tr. ferri chlor. enough ammonia 
water or sodium carbonate to form a precipitate, which 
will appear almost instantly. Continue adding the 
alkali until no more of the precipitate falls; then turn 
it into a piece of muslin or a fine strainer and wash it 
well by letting cold water run freely through it, until 
all traces of the soda or ammonia are removed. Stir 
up a tablespoonful of the precipitate in milk or water, 
and give it, repeating as often as necessary. It is 
harmless. About 8 grains of it are required to 
neutralize 1 grain of the poison. 



74 MATERIA MEDTCA FOR NURSES. 

Ferri Hydroxidum cum Magnesii Oxido. 
Ferric Hydroxide with Magnesium Oxide. 

Made by combining the solution of the ferric sulphate 
with magnesia. It is said to be the best antidote for 
arsenic. 

Dialyzed Iron. 

An antidote to arsenic; also given medicinally. It 
is said that it does not blacken the teeth nor constipate. 
Dose, from 20 to 40 drops. It should always be given 
alone. 

Manganesium (Manganese). 

Manganese is found native in the form of the black 
oxide. 

Physiological Actions. 

Manganese is found in the human body associated 
with iron. They are found together in the blood, hair, 
and bile, the proportion in the blood being 1 part of 
manganese to 20 of iron. The preparations of man- 
ganese are gastro-intestinal irritants. In small doses 
they aid digestion and promote appetite. They 
enter the blood probably as albuminates. Used in ex- 
cess the}' lower the heart action, diminish the pulse 
rate, and cause loss of muscular power and paralysis. 

The action of manganese on the tissues, blood, and 
excretory organs is not clearly denned. It is supposed 
that the salts are decomposed before being absorbed, 
except when in poisonous doses. 

Preparations of Manganese. 

Potassii Permanganas. 
Potassium Permanganate. 

Made from the black oxide of manganese, potassium 
chlorate, and a solution of caustic potash, by a very 
elaborate chemical process. It has the form of dark- 
purple slender prisms, inodorous, with an astringent, 



THE METALS. 75 

sweet taste; soluble in 16 parts of water. It should 
be kept in the dark. 

Potassium permanganate in the pure state is irritant 
and caustic. In solution it is stimulating and heal- 
ing. In the latter form it gives out oxygen in the form 
of ozone, and changes into hydrated peroxide of man- 
ganese, losing its purple color and becoming brown. 
This change does not occur with the crystals. 

This oxidizing power gives it special attributes as an 
antiseptic, disinfectant, and deodorant, but prac- 
tically it is not useful in disinfecting excreta, as the 
amount required to be effectual would make it enor- 
mously expensive. 

It is oftenest and most satisfactorily used as a deodor- 
izer, in the one-per-cent solution, as a wash, douche, 
spray, or gargle, for foul, carious, or gangrenous dis- 
charges. It is also used in skin disinfection, in a 
supersaturated solution. 

The stains made upon linen by this salt may be re- 
moved with oxalic acid, lemon juice, or water with 
muriatic acid. 

Given internally, the dose, gr. ss.-ii., is freely diluted 
with distilled water; or, if given in pellets, boiled or 
filtered water should be given with it to dilute it after 
being swallowed. It should be given on an empty 
stomach. 

Mangani Sulphas. 
Manganese Sulphate. 

In full doses an emetic and cathartic, with action 
on the liver, as is shown by the bile discharged after 
purgative doses. Dose, gr. ii.-v. (0.1-0.3 Gm.) 

Hydrargyrum (Mercury). 

Quicksilver. 

Mercury is obtained from cinnabar by roasting and 
distilling with lime. It is a silver-white metal, liquid, 
and giving off vapor at ordinary temperatures, and 
capable of being entirely volatilized by heat. All the 



y6 MATERIA MED1CA FOR NURSES. 

different preparations are derived directly or indirectly 
from the metal itself. 

Physiological Actions. 

In the metallic form mercury is inert, large amounts 
of the pure metal having been swallowed and dis- 
charged from the intestines without poisoning or injury; 
but in the form of vapor, or any of its preparations, it is 
very readily absorbed by the pulmonary and other 
mucous membranes, by the alimentary canal, and by 
the skin and tissues, either whole or broken. The 
constitutional effects may be reached in any one or all 
of these ways. 

All mercurials are antiseptic and disinfectant. 

The local action of mercury in moderate strength, 
either externally or internally, is astringent, anti- 
phlogistic, and stimulant. In large or concentrated 
doses it is irritant to the stomach and intestines, and in 
some forms is a locally acting purgative. 

In various pathological conditions of the system 
mercury exerts an influence as an alterative, through 
some power over nutrition which is not perfectly under- 
stood. It is considered a specific in some forms of 
syphilis. 

Mercury is excreted by the saliva, perspiration, 
milk, urine, and bile. 

Symptoms of Poisoning. 

The mildest evidences of over-doses of mercury are: 
slight fetor of the breath and soreness if the teeth are 
knocked together or struck; a metallic taste next ap- 
pears. After this comes salivation, an abnormal amount 
of fluid being poured out from the salivary glands, and 
small ulcers appear on the lips, gums, and tongue. A 
feeling of constriction of the throat, which is found 
among the symptoms of acute poisoning, has been 
caused in some susceptible persons by a single medici- 
nal dose of mercury. 

When its use is continued beyond this point saliva- 



THE METALS. 77 

tion increases. The gums become swollen and spongy, 
and bleed easily. The tongue swells, sometimes pro- 
truding from the mouth. The teeth are loosened, and 
a dark line is seen at their upper margin. In some 
cases ulceration of the soft parts and necrosis of the 
jaw-bones result. In pronounced chronic poisoning, 
in addition to these symptoms, there are abdominal 
pains, nausea, vomiting and diarrhoea, anaemia, ema- 
ciation and general weakness; aching pains in the 
bones and joints; loss of hair; a trembling or shaking 
palsy; and paralysis, with a brown tint of the skin. In 
some cases there is wrist-drop. Chronic poisoning may 
be caused indirectly by exposure to the metal or its 
fumes, as in various occupations, and it may come on 
very suddenly. 

When chronic poisoning by mercury is evident, the 
drug should be stopped immediately, the throat and 
mouth gargled regularly with a solution of potassium 
chlorate, and atropine may be given to lessen the exces- 
sive secretion of saliva, while potassium iodide is used 
to eliminate the mercury from the tissues. 

Acute poisoning will be described under corrosive 
sublimate. 



Preparations of Mercury. 

Hydrargyri Chloridum Corrosivum. 
Corrosive Mercuric Chloride. 
Corrosive Sublimate. 

Known as bichloride of mercury, or " bichloride." 
Made by subliming bisulphate of mercury with chloride 
of sodium. Soluble in 16 parts of cold water. It is a 
powerful germicide under certain conditions, and is 
ordinarily used as a disinfectant solution for the skin, 
for dressings, etc., in a strength of 1:1000. It is not 
an efficient disinfectant in the case of stools, or bloody 
or purulent discharges, as it hardens albumin, thus 
forming a protective shell within which germs retain 
perfectly their vitality. White materials are stained 



78 MATERIA MEDICA FOR NURSES. 

yellow by bichloride of mercury, and it is not always 
desirable therefore as a disinfectant for clothing. 1 

The external use of bichloride of mercury, as in dress- 
ing surgical and obstetrical cases, may produce symp- 
toms of poisoning which must not be overlooked. 
Among the latter class of cases an eruption of small 
pimples appears about the buttocks and may extend 
down the limbs. Sore gums, fetid breath, and saliva- 
tion may follow. The eruption should always be 
reported as soon as noticed. In chronic poisoning by 
this preparation there is more tendency to abdominal 
pains, diarrhoea, and colic. 

Internally in small over-doses it causes nausea, burn- 
ing in the stomach, colicky abdominal pain, and 
diarrhoea; or, these symptoms may not be prominent 
and a sore ulcerated mouth may show the toxic action. 
In poisonous doses it is a violent irritant and caustic, 
and the symptoms appear in a few moments — viz., a 
metallic taste, the mucous lining of the mouth some- 
times glazed and white, vomiting of mucus and blood, 
dysenteric purging, tenesmus, and cramps, with fetid 
breath. Violent abdominal pain is sometimes, not 
always, present. The urine is diminished, may con- 
tain blood and albumin, may be suppressed. In the 
course of two or three hours there is collapse, with 
small, quick, irregular pulse, pinched, anxious face, 
cold extremities, syncope, convulsions, coma, and 
death. 

The smallest fatal dose is not absolutely certain, but 
may be put at 3 to 5 grains. Death usually takes place 
in from 1 to 5 days, but may be earlier or later than this. 
On recovery the convalescence is long and tedious. 

The antidote is albumin, milk, gluten (flour), or, best 
of all, the white of egg, in proportion of 1 egg to 4 
grains of the poison. More than this is said to redis- 
solve the mercury. 



1 For this purpose the solution of salt and sulphate of zinc is 
better. See zinc. 



THE METALS. 79 

Vomiting should be promptly induced and actively 
kept up for a time after taking the antidote. 

Dose, gr. ■£$-■£$ (0.0013-0.003 Gm.), well diluted and 
given after meals. All other non-purgative prepara- 
tions are, as a rule, taken after meals also. 

Hydrargyri Oxidum Flavum. 
Yellow Mercuric Oxide. 

Dose, gr. -^V~tV (0.0013-0.006 Gm.) 

Hydrargyri Iodidum Flavum. 
Yellow Mercurous Iodide. 
Protiodide of Mercury. 

Dose, gr. T V"4. (0.006-0.03 Gm.) 

Hydrargyri Iodidum Rubrum. 
Red Iodide of Mercury. 
Biniodide of Mercury. 

Dose, gr. 3V-TV (0.002-0.006 Gm.) 

Hydrargyri Chloridum Mite. 
Mild Mercurous Chloride. 
Calomel. 

Made by subliming sulphate of mercury and chloride 
of sodium. A white, insoluble powder, used as a 
cathartic and indirect cholagogue. 

It increases the amount of bile evacuated from the 
intestines without directly increasing the amount 
secreted by the liver. In the ordinary routine of diges- 
tion part of the bile in the intestines is re-absorbed and 
carried back to the liver; but by the action of calomel 
this is all expelled from the body, the result being that 
the next quantity secreted must all be newly formed, 
out of fresh materials. 

Salivation occurs more frequently from the use of 
calomel than from other mercurials except blue pill, 
and it has an insidious harmful effect on the teeth, 
tending to retract the gums and expose the unprotected 



80 MATERIA MEDICA FOR NURSES. 

roots. Being tasteless and insoluble, it is best given 
dry on the tongue, with some water after it. It is slow 
in its action, requiring from 8 to 12 hours if given alone. 
Salty food should not be taken after calomel, as alka- 
line chlorides change it into bichloride. Acids also are 
often forbidden, though this is not now considered very 
important. 

Children bear relatively larger doses of calomel than 
do adults. Dose, gr. iV~S r « v - (0.006-0.325 Gm.) 

Massa Hydrargyri. 
Blue Mass. 

Made by combining mercury in the metallic state 
with glycyrrhiza, althaea, etc. It contains one third 
its weight of the metal, and is used, like calomel, as a 
purgative, but is milder. Each pill contains usually 
from 3 to 5 grains of the mass, equalling gr. \ of metal. 
Dose, gr. i.-v. (0.06-0.325 Gm.) 

Hydrargyrum cum Creta. 
Mercury with Chalk. 

A gray powder, similar in its properties and strength, 
to blue mass. It may be placed dry on the tongue or 
mixed with glycerin. Dose, gr. i.-v. (0.06-0.325 
Gm.) The mercurial purgatives are abused by num- 
bers of persons who prescribe for themselves. They 
should never be taken without authority, and it is also 
to be remembered that many quack purgative medi- 
cines, " liver pills," etc., contain mercury in uncertain 
quantities, and are harmful. 



Unguentum Hydrargyri. 
Mercurial Ointment. 
Blue Ointment. 

Composed of mercury, lard, suet, and oleate of 
mercury. 



THE METALS, 8l 

Unguentum Hydrargyri Oxidi Flavi. 
Ointment of Yellow Oxide of Mercury. 

Strength, 10 $. 

Unguentum Hydrargyri Oxidi Rubri. 
Ointment of Red Oxide of Mercury. 

Strength, 10 <$>. 

Unguentum Hydrargyri Nitratis. 
Ointment of Nitrate of Mercury. 
Citrine Ointment. 

Strength, 7 <f,. Contains also nitric acid. 

Black Wash. 
Calomel 3 i, lime-water O. j. Used externally. 

Yellow Wash. 

Corrosive sublimate 3 ss, lime-water O. j . Used 
externally. 

These two washes depend for their efficacy on the 
black and yellow oxides which are formed by the 
union with lime-water. They are used for syphilitic 
ulcers. The yellow wash is the more stimulating. 

Mercury, besides being given internally, is used in 
the form of vapor baths and inunctions. There are 
many preparations, and with all of them constitutional 
symptoms are likely to appear, and must always be 
watched for. 

It is of great importance that the diet of persons 
taking mercury should be ample and nutritious. The 
bowels should be kept open and the teeth should be 
kept clean in order to prevent salivation, at the same 
time pushing the drug to its physiological limit. 

Mercurial ointment should be rubbed in with a piece 
of flannel; nurses have been salivated by using their 
hands for this purpose. 



82 MATERIA MEDICA FOR NURSES. 

Arsenium (Arsenic). 

Metallic arsenic is inert, and is not used in medicine. 

Arseni Trioxidum. Arsenic Trioxide. 
Arsenous Acid. 
White Arsenic. 

Obtained principally as a secondary product in the 
roasting of cobalt ores. It is not a true acid, but an 
anhydride, or acid deprived of its water. All the prep- 
arations of arsenic are derived from white arsenic. 

Physiological Actions. 

Arsenic in concentrated form applied to the tissues 
causes inflammation, followed by ulceration and 
sloughing. It has therefore been used as an escha- 
rotic, but its action is very painful and is attended 
with danger, as arsenic is readily absorbed from broken 
skin, ulcers, and mucous membrane, unless there is 
enough inflammation to throw it off; it being under- 
stood that when an inflammatory process is going on, 
the absorptive capacity of that part is checked. 

In the stomach in medicinal doses arsenic does not 
combine with the albuminons contents of the organ, 
but remains unchanged and acts directly on the mucous 
membrane, stimulating the nerves and vessels, caus- 
ing a sense of heat and hunger, and promoting the 
gastric functions. 

Arsenic enters all organs and tissues, increases tissue 
changes and the vital activity of the whole system. 
It does not combine with the tissues, and is excreted 
chiefly by the urine, and also by the skin, liver, and 
intestines. Arsenic is therefore, in medicinal doses, a 
stomachic and general tonic, increasing the appetite 
and improving digestion and general nutrition. 

It stimulates the secretions, peristaltic action, the 
brain, heart, and respiratory centre. 



THE METALS. 83 

Symptoms of Poisoning. 

In giving arsenic, the first signs which indicate over- 
dosing are: a slight puffiness about the eyelids, without 
redness, and noticeable first in the early morning, dis- 
appearing later; an itching of the eyelids; tingling or 
itching of the fingers, abdominal pain or soreness. In- 
creasing symptoms of over-dosing are: a metallic taste, 
nausea, vomiting, diarrhoea, and sometimes dysenteric 
stools, with tenesmus; an irritable and feeble heart 
action; palpitations and oppressed breathing; eczema 
and other skin eruptions; trembling and stiffness of the 
joints; and albuminuria. 

In acute arsenical poisoning two effects are produced 
upon the tissues: 

1. The epithelium of mucous membranes is desqua- 
mated, especially in the alimentary canal. 

2. The blood-vessels in the splanchnic area are 
widely dilated. 

These two conditions give rise to clear watery stools 
— "rice water stools," — which are characteristic of 
arsenical poisoning and Asiatic cholera. 

In acute poisoning the symptoms are of two varieties, 
gastro-intestinal and cerebral. The former is much 
more common, and is marked by a burning pain at the 
epigastrium, radiating over the abdomen; violent and 
uncontrollable vomiting of matter, first mucous, then 
bilious, and finally serous; intense thirst and dryness 
of the mouth and throat; stools bloody and offensive, 
sometimes involuntary; strangury; sometimes bloody 
urine, or suppression; great restlessness and agitation; 
dyspnoea ; a rapid, weak, intermittent pulse ; cold 
breath; shrunken face; cold and clammy skin, and 
final collapse, consciousness being retained until death 
occurs. In the cerebral form there is sudden and deep 
insensibility, ending in death, without intestinal symp- 
toms. Occasionally there is a combination of both sets 
of symptoms; also they may vary according to the form 
and dose in which the poison has been taken. The 
time in which they come on is usually from half an 



84 MATERIA MEDIC A FOR NURSES. 

hour to an hour after taking the poison, and death has 
occurred in a few hours, but the average length of time 
is about twenty-five hours. It often happens that re- 
covery is made from the first effects, with death from 
exhaustion or secondary causes many days, or even 
weeks, after. 

The signs to be watched for in the administration of 
arsenic are: 

i. Pufhness about the eyes in the early morning. 

2. Constriction of the throat. 

3. Gastric disturbances — indigestion, pain, nausea, 
etc. 

4. Pigmentation of the skin. 

5. " Rice water stools." 

The arsenic should be discontinued for a short time, 
but may be resumed unless the symptoms were alarm- 
ing. 

The fatal dose for an adult may be put at from 2 to 4 
grains. 

Treatment of Poisoning. 

In treating poisoning by arsenic, if vomiting has not 
already been caused by the poison, emetics should be 
given: a tablespoonful of mustard in a glass of warm 
water, followed by large quantities of mucilaginous and 
albuminous drinks, such as flaxseed tea, milk, with 
white of Qgg, etc. The antidotes, hydrated sesquiox- 
ide of iron and hydrated magnesia, have been described 
under iron and may be given in water, a tablespoonful 
at a time, every few minutes while necessary. Castor- 
oil should be given to clear the bowels. If the poison 
has been taken in solution, the antidotes will precipitate 
it in an insoluble form, but no confidence can be placed 
in them if the powder has been taken, as rat-poison 
(often used in suicidal cases). The early and complete 
removal of the poison by emetics and purgatives is then 
the only real hope. The urine must be watched, as 
suppression may occur, and, while the patient lives, a 
daily specimen saved for examination. 

Arsenic is not accumulative, and is an irritant, not 



THE METALS. 85 

a corrosive, poison. After death the stomach and in- 
testines are found to be deeply reddened and inflamed, 
but not ulcerated. The post-mortem appearances, as 
-well as many of the symptoms, resemble those of chol- 
era very strongly. Chronic poisoning is caused by the 
inhalation of arsenical fumes, by the use of wall-papers 
and clothing dyed with materials containing arsenic, 
and by eating adulterated candy and other articles of 
food. 

Preparations of Arsenic. 

Arseni Trioxidum. 
Arsenic Trioxide. 
Arsenous Acid. 

Dose, gr. -gV-iV » we ^ diluted and given after meals. 
(0.0013-0.006 Gm.) 

Liquor Acidi Arsenosi. 
Solution of Arsenous Acid. 

Contains arsenic trioxide 1 part in 100, and dilute 
hydrochloric acid 5 parts in 100. 

Dose, TTt ii.-x. (TT], x. = gtt. x.), well diluted and 
given after meals. (0.1-0.65 Gm.) 

Liquor Potassii Arsenitis. 
Solution of Potassium Arsenite. 
Fowler's Solution of Arsenic. 

Contains tr. of lavender and arsenic trioxide and 
bicarbonate of potassium, 1 part of each in 100. Five 
minims represent gr. -£%. 

Dose, TTL ii.-v. (til x. = gtt. x.), well diluted and 
given soon after meals. (0.1-0.325 Cc.) 

Arseni Iodidum. 
Iodide of Arsenic. 

Dose, gr. ^V~tV (0.002-0.006 Gm.) 



86 MATERIA ME DIC A FOR NURSES. 

Liquor Arseni et Hydrargyri Iodidi. 
Solution of Arsenous and Mercuric Iodide. 
Donovan's Solution. 

A very powerful alterative, containing i % each of 
iodide of arsenic and red iodide of mercury. It is 
capable of acting as a corrosive poison, and may sali- 
vate. Locally it is a violent irritant. 

Dose, 3-5 min., well diluted. (0.008-0.325 Cc.) 

Cupri Arsenis. 
Paris Green. 

Is not used medicinally, but is often taken as a means 
of suicide. 

It may be repeated in conclusion that all preparations 
of arsenic should be given well diluted, and soon after 
meals, to avoid the local irritant action on the stomach; 
and that it is necessary to keep close watch for the con- 
stitutional symptoms, which may at first be so unob- 
trusive as to escape notice. 

Antimonium (Antimony). 

The metal itself (stibium) is not official, all prepara- 
tions being derived from black antimony, which is 
obtained from siliceous matter, purified and powdered. 

Antimonii et Potassii Tartras. 
Antimony and Potassium Tartrate. 
Tartar Emetic. 

Made 03' boiling cream of tartar and water with 
oxide of antimony. 

Tartar emetic, applied to the skin, is a strong coun- 
ter-irritant, and excites an eruption closely resembling 
that of smallpox, viz.. small papules, becoming vesicu- 
lar and finally pustular. It is now but little used in 
this way. Internally it is irritant, and, as an emetic, 
its action is partly direct — that is, acting immediately 



THE METALS. 87 

on the walls of the stomach, and partly indirect, or 
acting on the nerve-centre in the medulla which con- 
trols vomiting. Tartar emetic causes nausea and de- 
pression both before and after the act of vomiting, and 
is therefore not well suited to cases where rapid action 
with as little depression as possible is required, as in 
poisoning. 

In small continued doses the local action of tartar 
emetic is apt to produce loss of appetite, nausea, diar- 
rhoea, and pain. In the tissues antimony has an alter- 
ative action, the special results being an increase of the 
waste products of the body, with a lessening of oxygen- 
ation, and fatty degeneration of the organs. 

Tartar emetic depresses the circulation even in small 
doses, the first effect visible after a therapeutic dose 
being a diminution of the pulse and increase of per- 
spiration. 

With a continuance of the medicine the pulse be- 
comes weakened, soft, and compressible, infrequent 
and irregular, and fainting may occur. Respiration is 
weakened, inspiration being shortened, and expiration 
lengthened. 

The nervous system is depressed, a feeling of languor, 
sleepiness, and lassitude being produced by a moderate 
dose. It affects the muscular system so powerfully 
that before chloroform came into use tartar emetic was 
employed to produce muscular relaxation in the reduc- 
tion of dislocations, etc., and the depressed state so 
brought about lasted for six or eight days in spite of 
heart stimulants. 

Hmetic doses cause great muscular weakness, trem- 
ors, and aching of the muscles, loss of power to stand, 
with free perspiration and an increase of saliva. 

Antimony is excreted by all the mucous surfaces, the 
liver, kidneys, and skin. 

Its excretion by the bile shows it to be a hepatic 
Stimulant ; in passing through the kidneys it acts as 
a diuretic, and through the skin as a diaphoretic. 

The characteristic pustular eruption is sometimes 
caused by its internal use. 



88 MATERIA MEDICA FOR NURSES. 

Symptoms of Poisoning, 

The symptoms of poisoning are very like those of 
the collapse of cholera, viz.: shrunken features, cold 
surface and breath; great epigastric pain, vomiting, and 
purging; small, rapid, soft, and irregular pulse; cyano- 
sis; syncope; cramps of the lower extremities; insen- 
sibility to stimulants; intense prostration; delirium; 
tetanic spasms in some cases, or aphonia. 

The quantity of tartar emetic which will destroy life 
is not definitely know T n. The smallest fatal dose re- 
corded is f of a grain in the case of a child; gr. ii. has 
caused death in an adult, while doses have been re- 
covered from, ranging from gr. xx. to § i. It is prob- 
able that, under ordinary circumstances favoring the 
action of the poison, gr. x. or xv. would destroy life, if 
taken at once, or a smaller quantity, if divided. The 
symptoms come on rapidly, and death may occur in a 
few hours, or days, or may be delayed for several weeks. 

Treatment of Poisoning. 

The antidote is tannic acid; or substances containing 
it, as strong tea. Opium, and alcoholic stimulants, 
with demulcent drinks, are given. 

Dose of tartar emetic, gr. ^-i. , diluted. (0.005-0.06 
Gm.) 

Vinum Antimonii. 
Wine of Antimony. 

Contains of tartar emetic gr. ii. to % i. 
This preparation decomposes on being kept, and a 
fungoid growth takes place in it which unfits it for use, 
Dose, Tit v. (Tit x. = gtt. xii.)-3ss. (0.3-2. Gm.) 

Syrupus Scillae Compositus. 
Compound Syrup of Squill. 

Contains squill, senega, sugar, and water, with tartar 
emetic, about gr. § to § i. Syrup of squill is some- 
times used as a domestic remedy for children, without 



NON-METALLIC ELEMENTS. 89 

a physician's order, and as tartar emetic is not a safe 
medicine for children, its unauthorized use has some- 
times had fatal effects, and should always be strongly 
discouraged. 

Bismuthum (Bismuth). 

A crystalline metal, impure in its crude state, and 
containing arsenic as one of the impurities. It goes 
through various chemical processes by way of purifica- 
tion. 

Physiological Actions. 

Externally and internally bismuth acts as a mild 
sedative and astringent. It is useful as a dry appli- 
cation in the first stages of bed-sores, as a dressing for 
burns and blisters, and may be satisfactorily used on 
small fresh wounds. It is given internally as an astrin- 
gent, and in large quantities colors the faeces black or 
dark-gray. 

Bismuthi Subnitras. 
Subnitrate of Bismuth. 

A heavy white powder, odorless and almost taste- 
less, insoluble in water. The easiest way to give it is 
mixed in a little glycerin and diluted w 7 ith milk or 
water; or it may be given in wine, or placed dry on the 
tongue. 

Dose, gr. v.-3i. (0.3-4. Gm.) 

NON-METALLIC ELEMENTS. 

Phosphorus (Phosphorus). 

A non- metallic element made from bones, by treating 
bone-ash with sulphuric acid and water. It is a semi- 
transparent, almost colorless, wax-like solid, with a 
peculiar garlic odor; it is luminous in the dark, is in- 
soluble in water, and soluble in ether and in oils. 



90 MATERIA MEDICA FOR NURSES. 

Phosphorus is a constituent of the most important 
tissues of the body, especially of the nervous system, 
where it exists as phosphorized fats. In the bones it 
is present as phosphate of calcium, magnesium, and 
sodium. It is contained in various articles of food, 
especially in fish and vegetables. 

Physiological Actions. 

In small doses phosphorus acts as a tonic and alter- 
ative, and stimulates the nutritive processes, especially 
in the case of the nervous and bony tissues. Given for 
a considerable length of time in small doses it affects 
the structure of bone, and makes the spongy portion 
firm and compact. The heart is stimulated by medici- 
nal doses of phosphorus, and the temperature slightly 
raised. 

Full doses given for a long time disturb the stomach, 
producing eructations of gas (phosphide of hydrogen), 
and depress the heart. Perspiration and urine are in- 
creased by phosphorus, and the latter becomes reddish 
and has the odor of violets. 

Phosphorus poisoning causes grave changes in met- 
abolism, indicated by lessened oxidation, and fatty de- 
generation in all the tissues of the body and cirrhosis 
of the various organs, stomach, liver, and kidneys, as 
well as necrosis of bone, especially of the jaw. 

Phosphorus is an irritant poison, and the symptoms 
vary somewhat according to the state in which it is 
taken, appearing more quickly after taking a solution 
in oil, or the paste used as a vermin killer, than after 
match heads or ordinary phosphorus have been used. 
In the latter case the symptoms do not come on at once; 
some hours usually — sometimes one or two days — in- 
tervening before they show themselves. Then epigas- 
tric pain and burning begin, with a burning sensation 
in the throat, a taste of garlic in the mouth, and an 
odor of garlic to the breath; great thirst, nausea, and 
vomiting. During the first eight or ten hours the 
vomited matters have a garlic odor and are luminous 



NON-METALLIC ELEMENTS. 9 1 

in the dark, and if purging occurs, the faecal matters 
are sometimes luminous, as is also the urine. Vomit- 
ing sometimes continues through the whole of the 
attack, but usually stops about the second or third day. 
Jaundice is a characteristic but not an invariable 
symptom. It appears from the third to the fifth day, 
and with it vomiting may reappear, exuded blood 
giving a peculiar appearance which is described as 
"coffee-ground." There is great prostration, with a 
small, frequent, almost imperceptible pulse, and cold 
skin. The mind may remain clear, or there may be 
noisy delirium Sometimes convulsions occur, or 
paralysis. Death may take place suddenly from col- 
lapse and paralysis of the heart, but more commonly 
the patient dies comatose from gradual failure of res- 
piration and circulation. The time at which death 
occurs varies from a few hours to several weeks, the 
average time being several days or a week. 

The fatal dose is stated to be between gr. § and ii., 
though it may vary according to circumstances, and 
large quantities have been recovered from. 

Treatment of Poisoning. 

The chemical antidote is the crude French acid tur- 
pentine, which is given in doses of 3 ss. every fifteen 
minutes. After the poison has entered the blood there 
is no known antidote, and therefore emetics and purga- 
tives are of the greatest importance. Sulphate of 
copper is the emetic used, and forms an insoluble com- 
pound, phosphide of copper. It is given in dilute solu- 
tion, gr. ii. at a time, every five minutes until vomiting 
is caused, and after that in small doses, gr. J, every 
twenty minutes as long as ordered. Hydrated mag- 
nesia may be used as a purgative. Mucilaginous and 
albuminous drinks are given, and all oils and fats care- 
fully avoided, both in medicine and nourishment, as 
they dissolve phosphorus and hasten its absorption. 

Chronic phosphorus poisoning is found among arti- 
sans who are exposed to the fumes, and is especially 



92 MATERIA MEDIC A FOR NURSES. 

characterized by necrosis of the jaw. This form of 
poisoning is not as common now, since improved ways 
of making matches have been introduced, as it once 
was. 

Preparations of Phosphorus. 

Pilulae Phosphori. 
Pills of Phosphorus. 

Each contains gr. T J ¥ of phosphorus. (0.0006 Gm.) 

Calcii "I Calcium 

^ erd .. Y Hypophosphis. * ron . y Hypophosphite. 

Potassn J r Potassium f J * r * 

Sodii J Sodium J 

Dose, gr. x.-3ss. (0.65-2. Gm.) 

Syrupus Hypophosphitum. 
Syrup of Hypophosphites. 

Contains hypophosphite of lime, about gr. iii. to 3 i, 
and of soda and potash each about gr. i. to 3 i., with 
dilute hypophosphorous acid, tincture of fresh lemon 
peel, and sugar. 

Dose, 3 i- 3 n\, diluted. (4-8 Gm.) 

Chlorum (Chlorine). 

Chlorine is a greenish-yellow gas, belonging to the 
halogen group of elements. The title " halogen " is 
derived from the Greek word meaning sea, and is so 
given because the most important members of the group 
are obtained directly or indirectly from the ocean — viz. : 
chlorine, obtained from sea-salt; bromine, from sea- 
water; and iodine, from sea- weed. 

Chlorine itself is not official, but is represented in 
medicine by several of its compounds; also by hydro- 
chloric acid and chlorinated lime, by which it is 
furnished. Chlorine is irrespirable, and of strong 
penetrating odor. It is soluble in water, in the propor- 
tion of two parts gas to one part water. If inhaled in 



NON-METALLIC ELEMENTS. 93 

any quantity it irritates the lining of the air-passages, 
causes spasm of the glottis, and narcotizes the brain. 

It is a most powerful disinfectant, antiseptic, and 
deodorant, its great activity in these respects being 
due to its affinity for hydrogen, by which it decom- 
poses compounds containing hydrogen, and sets oxygen 
free in its most active state, as ozone. It is not used 
in disinfecting clothing, as it destroys the color and 
texture of fabrics, nor the person, as it cannot be 
breathed in a strength sufficient to destroy germs. 
For disinfecting rooms it may be prepared as follows: 
Mix equal parts of common salt and black oxide of 
manganese. To a tablespoonful of this powder, in a 
saucer, add a tablespoonful ( | ss.) of strong sulphuric 
acid diluted one third with water. In cold weather the 
saucer should be heated. This will produce enough 
chlorine to disinfect a room thirty-two feet square. 

Calx Chlorinata. 
Chlorinated Calcium Oxide. 
Chlorinated Lime. 

Made by the action of chlorine on slaked lime, con- 
taining 30 per cent, chlorine. Its action as a disin- 
fectant is that of chlorine, and when so used it should 
be perfectly fresh or it is valueless. To test it, dissolve 
a little in water; if the solution is clear it is good, but 
if it has lost its chlorine the solution will be turbid 
and milky. This preparation is sometimes improperly 
called chloride of lime. 

Liquor Sodas Chlorinatae. 
Solution of Chlorinated Soda. 
Labarraque's Solution. 

Contains sodium carbonate and chlorinated lime. A 
greenish- yellow liquid, with sharp salty taste and very 
slight odor of chlorine. It is a good preparation for 
cleansing purposes in sick-rooms, wards, etc., in weak 
solution. In full strength it removes stains from glass. 
Medicine droppers, douche nozzles, and other small 
articles which are hard to clean may be soaked in it 



94 MATERIA MEDICA FOR NURSES. 

until the stains come away. It is sometimes given 
internally, in half a tumblerful of sweetened milk or 
water. 

The antidote, in case of poisoning by any of the 
chlorine compounds, is albumin: white of egg, milk 
and flour. Dose, 3 J-ss. (1-2 Cc.) 

Bromum (Bromine). 

A liquid element obtained from sea- water and from 
certain mineral springs. A dark, brownish-red, very 
volatile liquid, of strong and suffocating odor. When 
brought into contact with organic matter it oxidizes 
and destroys it with great rapidity. Its local action 
is, therefore, powerfully irritant and escharotic. It 
is also a deodorant and antiseptic. It is never given 
internally, alone, but has been used as a caustic, and 
the vapor has been used medicinally. 

Preparations of Bromine. 

Potassii Bromidum. 
Potassium Bromide. 

Prepared by adding a solution of pure carbonate of 
potash to a solution of bromide of iron, filtering, and 
evaporating. Colorless crystals, soluble in i t 6 q parts 
water. 

Physiological Actions. 

Potassium bromide lessens cerebral activity, and the 
tendency to ' ' emotionalism ' ' ; diminishes the sensibil- 
ity and irritability of the mind in various nervous states; 
such, for instance, as result from excessive mental 
strain, anxiety, or intellectual work; and produces a 
condition of anaemia of the brain such as is found in 
natural sleep. It is thus an indirect hypnotic, not 
acting like opium or chloral, but inducing sleep by 
bringing about a physiological condition favorable to 
its advent. Bromide of potash is depressing to the 



NON-METALLIC ELEMENTS. 95 

heart and respirations, both being slowed and weak- 
ened by its action. The spinal centres, spinal nerves, 
and the muscles are all depressed, and the temperature 
somewhat lowered, though not to any marked extent. 
Bromide of potassium contains 66 per cent, of bromine. 
Dose, gr. x.-xx. (0.65-1.3 Gm.) 

Ammonii Bromidum. 
Ammonium Bromide. 

Prepared by precipitating the freshly made solution 
of bromide of iron with ammonia water. The salt re- 
maining in solution is crystallized and powdered. It 
is soluble in \\ parts of water. The effects and uses of 
bromide of ammonia are very like those of the bromide 
of potash, and it is said to be, in addition, slightly 
stimulating. It is not much used. 

Dose, gr. x.-xx. (0.65-1.3 Gm.) 

Sodii Bromidum. 
Sodium Bromide. 

Colorless crystals, soluble in i T 2 y parts of water, and 
containing 97 per cent, of sodium bromide. It resembles 
potassium bromide, and has very much the same quali- 
ties. It is considered less depressing, and the least toxic 
of all the bromide preparations. There is a variety of 
opinions as to its hypnotic power compared with that of 
potassium bromide. 

Dose, gr. x.-xx. (0.65-1.3 Gm.) 

Lithii Bromidum. 
Lithium Bromide. 

A granular, very soluble salt, containing 97 per cent, 
of lithium bromide. In addition to the hypnotic power 
of the bromides in general it is said to have some tonic 
and diuretic action. 

Dose, gr. v.-xx. (0.3-1.3 Gm.) 

Incidental Effects. 

In giving a course of the bromides it is very essential 
that the state of the digestion and of the bowels be 



96 MATERIA MEDIC A FOR NURSES. 

carefully watched, and the latter strictly regulated, for 
the accumulation of an excess of bromine in the system 
causes a series of symptoms known as " bromism." 
The first is usually a salty taste in the mouth, with 
salivation and fetid breath. Next come drowsiness, 
heaviness, and sluggishness of intellect, loss of mem- 
ory, partial aphasia, depressed spirits, a staggering 
gait, dull, listless expression, sluggish pupils, and 
sometimes an infrequency of winking. 

One of the marked features of bromism is the appear- 
ance of eruptions of the skin, in great variety, and of 
varying severity. All manner of skin lesions have 
been described as resulting from the use of bromine, 
even to one resembling that of smallpox. The most 
common is a simple acne or eruption of pimples. It 
sometimes occurs early, or after the use of small doses, 
yet is not always among the first symptoms. Fowler's 
solution is given with the bromides to prevent acne. 

The bromides are excreted by the kidneys chiefly, 
also by the salivary and mammary glands, the skin, 
and all mucous surfaces. They are rapidly diffused, 
appearing in the secretions a few moments after being 
taken. 

Iodum (Iodine). 

Iodine is a non- metallic element of bluish color, 
derived chiefly from the ashes of sea- weeds; not read- 
ily soluble in water; soluble in ether, alcohol, and 
glycerin. It is never given internally in crude form. 

Physiological Actions. 

Applied externally iodine is an irritant and vesi- 
cant, and stains the skin yellow, or, in repeated appli- 
cations, deep brown. It causes some pain, with a 
feeling of warmth, and desquamation may follow its 
use. It is absorbed into the blood partly through the 
skin and partly in the form of vapor. 

The vapor of iodine, like that of chlorine, but in a 
feebler degree, decomposes sulphuretted and phosphu- 
retted compounds, and is, therefore, antiseptic and 



NON-METALLIC ELEMENTS. 97 

disinfectant. Internally iodine excites a sensation of 
heat and burning in the stomach. In sufficient quan- 
tity it is an irritant poison, causing inflammation of the 
lining of the stomach, severe pain in the abdomen, 
vomiting, and purging. The matters vomited have a 
yellow color, except when farinaceous food has been 
taken; in this case they are blue or purplish. The 
amount of iodine necessary to produce toxic symptoms 
varies with constitutional peculiarities and with the 
kind and amount of food in the stomach. Death has 
been caused in twenty-four hours by 3 i. The antidote 
is starch or flour stirred up in water, and emetics should 
be given afterwards. 

Iodine is rapidly excreted, appearing in the urine, 
the perspiration, saliva, bile, milk, and mucous secre- 
tions, especially of the air-passages. 

Preparations of Iodine. 

Potassii Iodidum. 
Potassium Iodide. 

Made by dissolving iodine in liquor potassae, evapo- 
rating, and treating the residue with wood charcoal. 

Potassium iodide is extremely diffusible and enters 
the blood with great rapidity. It acts in a general 
way as a tonic and stimulant to nutrition, accelerates 
tissue-changes, and increases the excretion of waste 
products. It has some slight diuretic action, and 
has the power of dislodging from the tissues vari- 
ous poisonous metallic substances, notably lead and 
mercury. 

The lymphatic glands are reduced in size by iodide 
of potash, and, like mercury, it has over some forms of 
disease a marked and positive influence, not thoroughly 
explainable. Its action in these cases is called " spe- 
cific " or <( alterative." 

Incidental Effects. 

In giving any of the iodides, and especially the iodide 
of potash, the peculiar set of symptoms known as 



98 MATERIA MEDICA FOR NURSES. 

1 * iodism ' ' must be carefully watched for. There is 
first an inflammation of the mucous membrane of the 
head resembling acute coryza, or catarrh; running at 
the eyes and nose, salivation, swelling of the eyelids, 
sneezing, and frontal headaches; sore-throat, hoarse- 
ness, and trouble in swallowing, with a feeling of gen- 
eral wretchedness, and rise in temperature. 

There are also several varieties of eruptions which 
may appear, said to be more likely to occur in the case 
of patients with diseased kidneys. The most common 
is an eruption of acne on the face, shoulders, and 
thighs, and eczema is also frequent. 

Debility and pains in the joints are sometimes 
noticed, and in some cases digestive disturbances 
result, with nausea and diarrhoea. 

The solution of i in i (Til i. = gr. i.) is best given 
in milk; or it may be given in cinnamon water, or the 
compound syrup of sarsaparilla, to disguise the un- 
pleasant taste. It is often ordered with bichloride of 
mercury, and they may be given together, but if it is 
not ordered in combination it should never be added to 
any other medicine, but given alone. 

By largely diluting it and giving it on an empty 
stomach, symptoms of iodism are in a measure avoided. 

Potassium iodide is given pleasantly and with great 
freedom in aromatic spirits of ammonia. 

Dose, gr. v.-3i. (0.3-4. Gm.) 

Liquor Iodi Compositus. 

Lugol's Compound Solution of Iodine. 

Composed of iodine and potassium iodide. Twenty 
minims contain gr. i. of iodine. 

Dose, Til i.-v. (fit x. = gtt. x.), well diluted. 
(0.06-0.3 Cc.) 

Tinctura Iodi. 
Tincture of Iodine. 

Contains 7 parts iodine, 5 parts potassium iodide, and 
88 parts alcohol. It is used externally as a counter- 
irritant; applied with a camel' s-hair brush, and in one 



NON-METALLIC ELEMENTS. 99 

or more coats as ordered. Each coat must dry sepa- 
rately. It cannot be diluted with water, as the iodine 
precipitates in water. If extreme burning follows the 
application, and it is desirable to wash it off, alcohol, 
or ether, or a solution of iodide of potash will remove 
it, or, still better, a weak solution of aqua ammonia. 

Unguentum Iodi. 
Iodine Ointment. 

Contains 4 parts in 100 of iodine, with 4 parts of 
potassium iodide, 12 parts glycerine, and benzoinated 
lard to make up the rest. 

Iodoformum. 
Iodoform. 
Iodide of Formyl. 

Iodoform is made by heating iodine with potassium 
carbonate, alcohol, and water, and allowing the crys- 
talline deposit to settle. It consists of small, bright- 
yellow, lustrous crystalline scales, with a very strong 
and clinging odor, and sweetish taste. It contains 
about 97 per cent, of iodine, and is freely soluble in oils, 
ether, and chloroform. It is slightly volatile at ordi- 
nary temperatures, and at a temperature above 239 F. 
emits vapors of iodine. In making sterilized iodoform 
gauze this iodine vapor will condense and turn the gauze 
brown unless free evaporation is allowed from the mouth 
of the jar or sterilizer. 

Iodoform was discovered in 1822, but was not used 
for some years. At various times since then its quali- 
ties have been referred to in medical articles, and within 
the last few years it has become very popular as an 
antiseptic in surgical dressings, — so much so that its 
use has been carried to excess and its reputation greatly 
exaggerated. Various cases of poisoning had the effect 
of checking its too lavish use, and its limitations as 
well as its powers are now more clearly known. 

It is no longer considered one of the most active 
germicides, as was claimed for a time, yet it has 

LWC. 



IOO MATERIA MEDIC A FOR NURSES. 

properties sufficient to give it a secure place in surgery. 
It prevents or arrests decomposition, promotes union 
and cicatrization in wounds, and is a deodorizer. It 
is not irritating, but acts rather as a local anodyne. In 
a wound treated with iodoform the secretion is lessened, 
and is serous rather than purulent in character. In 
cases of poisoning by absorption through a wounded 
surface, the following symptoms may occur: 

Rise of temperature as high as 104 F. , or higher. 
This may be the only symptom; or with it there may 
be headache, a rapid and compressible pulse, and loss 
of appetite, the symptoms going off as soon as the 
iodoform is discontinued. Iodine is found in the urine 
in iodoform poisoning. More serious effects are: a 
grave depression of the system, and anxious melan- 
cholia; a restless mental condition, with very weak and 
rapid pulse, perhaps reaching 180; drowsiness, delirium, 
and collapse. Death sometimes occurs quickly, even 
though the application be stopped. The amount cap- 
able of causing fatal poisoning has been recorded as 
varying from 500 grains upwards. In using iodoform 
the extent of exposed surface through which absorption 
may take place is of more importance than the actual 
amount applied, which may not all be absorbed. 

Iodoform is sometimes given internally, in pill or 
capsule. Dose, gr. i.-ii. (0.06-0. 13 Gm.) 

Unguentum Iodoformi. 
Iodoform Ointment. 

Iodoform 10 parts, and lard 90 parts. 

Iodolum. 
Iodol. 

Iodol is a new substance which has been chemically 
produced in the attempt to make an equivalent for 
iodoform, which should have its qualities without the 
unpleasant odor. It is obtained by the action of iodine 
on certain constituents of mineral oil, and contains 
about 85 per cent, iodine. It is a yellowish-brown 



NON-METALLIC ELEMENTS. IOI 

powder, which darkens on exposure to light. It is 
odorless, soluble in alcohol, ether, and chloroform; in- 
soluble in water. It is said to be as efficiently anti- 
septic and disinfectant as iodoform, having the same 
deodorant and anaesthetic properties, but it is not 
much used. 

Other derivatives of iodoform are : 

Aristol. Antiseptin. 

Europhen. Losophane. 

Antiseptol. Sozoiodol. 

Sozal. Sulphaminol. 
Thiophene. 

Sulphur (Brimstone). 

Sulphur is found native in volcanic districts as 
crude sulphur, and in combination with metals, as 
sulphides. 

Physiological Actions. 

Sulphur is used externally for its action on the skin. 
It has no local action of its own, but by contact with 
the products of the skin it changes into sulphuretted 
hydrogen and sulphides, which are active substances. 
In this form it is a vascular stimulant, a nerve 
sedative, a stimulant to the skin, and a diaphoretic. 

Taken internally it acts as a laxative, increasing 
peristalsis, and it has also probably some power of 
influencing nutrition. 

If taken for a long time it impairs the blood and 
causes emaciation, anaemia, trembling, and debility. It 
forms sulphuretted hydrogen in the intestines, giving 
an unpleasant odor to the faeces, and the same dis- 
agreeable odor is imparted to the perspiration, by the 
excretion of sulphur through the skin. Silver jewelry 
worn by a patient taking sulphur becomes discolored 
by the excretions of the skin. 



102 MATERIA MEDICA FOR NURSES. 

Preparations of Sulphur. 

Sulphur Sublimatum. 
Sublimed Sulphur. 
Flowers of Sulphur. 

Prepared from crude sulphur (which compressed into 
molds forms the roll sulphur used in fumigating) by 
subliming. A yellow powder, tasteless, and odorless 
until heated, and insoluble in water. It always con- 
tains a little sulphuric acid, and is used only in making 
other preparations. 

Sulphur Lotum. 
Washed Sulphur. 

Sublimed sulphur washed with ammonia water and 
freed from acid. The action is laxative. It is given 
in powder mixed with simple syrup or molasses. Dose, 
3 i.— iii. , given at night. (4-12 Gm,) 

Potassa Sulphurata. 
Liver of Sulphur. 

Made by fusing sublimed sulphur with carbonate of 
potash. Solid greenish pieces, alkaline, and of very 
acrid taste; soluble in water, making an orange-colored 
solution. Locally applied, sulphurated potash is an 
irritant, and taken internally is a violent corrosive 
poison. It is used in ointments and in giving sulphur 
baths; in the latter case in a strength of from 3 i.-vi. to 
30 gallons of water. The bath may last from twenty 
minutes to two hours, and has a generally stimulat- 
ing effect. 

A papular eruption and eczema sometimes follow the 
use of sulphur. 

Unguentum Sulphuris. 
Sulphur Ointment. 

Sulphur in strength of i\ parts in 10, with benzoin- 
ated lard. 



NON-METALLIC ELEMENTS. IO3 

Ichthyol. 

A preparation obtained from a bitumen 1 found in the 
Tyrol, and supposed to be the residue of extinct fishes. 
It contains 10 per cent, of sulphur and is not irritating 
to the skin. It is used externally in an ointment of 
10-20 per cent, strength. It is useful as a sedative, 
antiseptic, and alterative. 

Carbo Ligni (Carbon). 
Charcoal. 

Charcoal is obtained from the combustion of bones, 
— carbo animalis, animal charcoal, or bone black — and 
of wood — carbo ligni, wood charcoal. 

Charcoal absorbs and condenses many gases and 
vapors, coloring matters, alkaloids, and other sub- 
stances in quantities many times greater than its own 
bulk; and when exposed to the air it thus increases 
rapidly in weight. For this reason, when intended for 
medicinal purposes it must be kept carefully covered in 
well-stoppered bottles. 

Externally it is used as an absorbent and deodo- 
rant, and internally as a carminative. It may be 
given between two slices of bread and butter, or mixed 
with wine. Charcoal does not enter the system, but is 
entirely expelled by the bowels. Dose, 3 ss.-i. (2-4 
Gm.) 

Aqua Hydrogenii Dioxidi. 

Solution of Hydrogen Dioxide. 

Peroxide of Hydrogen. 

A slightly acid watery solution of hydrogen dioxide, 
containing, when fresh, about 3 per cent., by weight, 
of the pure dioxide, corresponding to about ten volumes 
of oxygen. 

It is used in the treatment of ulcers, fetid suppura- 

1 An inflammable mineral substance. 



104 MATERIA ME DIC A FOR NURSES. 

tion, diphtheritic membranes, etc. Its virtues depend 
on its readiness to yield oxygen to all oxidizable sub- 
stances. 

As it soon loses strength, it should be kept in small 
quantities, in a cool place, not exposed to the light, 
and as it is an expensive article, should be carefully 
used. 

INORGANIC ACIDS. 
Acidum Sulphuricum (Sulphuric Acid). 
Oil of Vitriol. 

Sulphuric acid is made by passing in leaden chambers 
simultaneously the vapors of burning sulphur, nitric 
acid, steam, and air. 

It is a colorless, oily-looking, intensely acid liquid, 
containing 7.5 per cent, water. On exposure to the air 
it absorbs moisture. 

Physiological Actions. 

Sulphuric acid is a powerful corrosive, and ab- 
stracts water from animal and vegetable tissue, leaving 
carbon. It thus blackens organic matter while destroy- 
ing its texture. 

Concentrated and mixed in a paste with charcoal, 
sulphuric acid has been used as an escharotic. Di- 
luted, its special action both externally and internally 
is that of an astringent. 

Symptoms of Poison ing. 

When swallowed in concentrated form it corrodes the 
alimentary canal, causing acute pain of the mouth, 
throat, and epigastrium. The tongue and lining of the 
mouth are whitened, like parchment, afterwards turn- 
ing brown, while brown or blackened spots appear on 
the lips. 

There are: violent vomiting, of tarry matters often, 



INORGANIC ACIDS. 105 

cold extremities, and clammy skin; protuse and bloody 
salivation, suppressed voice, and feeble pulse. The 
face expresses great suffering and anxiety. The mind 
is clear. The matters at first vomited are acid, and if 
they fall on colored articles of dress the color is taken 
out and the texture destroyed; while on black material 
brown spots are produced, with an edge of red. 

There is sometimes perforation of the stomach or in- 
testines. The symptoms come on immediately after 
the act of swallowing, and death may result in a few 
hours, but usually delays for from 18 to 24 hours; 
occurring, finally, very suddenly. The smallest fatal 
dose recorded is 3 i. Usually § i. or more has been 
taken. 

Antidotes. 

The antidotes are chalk, magnesia, whitewash, or 
soap. They should be mixed in milk or water and 
given freely. 

Preparations. 

Acidum Sulphuricum Dilutum. 
Dilute Sulphuric Acid. 

Has a strength of 10 per cent, of the acid. 

Dose, Til x.-xxx. (ttx x. = gtt. x.). (0.65-2. Cc.) 

Acidum Sulphuricum Aromaticum. 
Aromatic Sulphuric Acid. 

Contains alcohol and aromatics, and acid in a strength 
of 20 per cent. Both these preparations should be given 
well diluted, and through a glass tube, to save the 
teeth from injury. 

Dose, Tit x.-xx. (TT[x. = gtt. xxiv.). (0.65-1.3 Cc.) 

Acidum Nitricum (Nitric Acid). 
Aqua Fortis. 

Nitric acid is prepared from nitre by distillation with 
water and sulphuric acid. A colorless, intensely acid, 



106 MATERIA MEDIC A FOR NURSES. 

fuming liquid, containing 68 per cent, acid, the rest 
water. 

Physiological Actions. 

It is a very powerful caustic, and if used in this way 
the sound tissues should be protected by a coating of 
oil or soap, or sheet-lint wet in a solution of bicarbo- 
nate of soda, and the spot cauterized be washed with 
warm soap-suds after sufficient effect has been obtained. 

Taken internally in medicinal doses it has stimulant 
and astringent properties. 

Poisoning and Antidotes. 

In concentrated form nitric acid is an exceedingly 
corrosive poison, even more violent than sulphuric 
acid. Iyike the latter, it destroys the membrane lining 
of the mouth, oesophagus, and stomach. The symp- 
toms are the same, except that nitric acid stains the 
tissues yellow instead of black. They come on with 
the same severity, and immediately. The antidotes 
are the same, and death occurs on an average in half a 
day, or a day. 

Preparations. 

Acidum Nitricum Dilutum. 
Dilute Nitric Acid. 

Has a strength of i part to 10. It must be well 
diluted and given through a glass tube. 
Dose, iU x. (m x. = gtt. x.). (0.65 Cc.) 

Acidum Hydrochloricum. 
Hydrochloric or Muriatic Acid. 

Hydrochloric acid is obtained by the action of sul- 
phuric acid on chloride of sodium, and solution of the 
fumes in water until it has a strength of about 30 per 
cent. An almost colorless, very acid liquid, with pun- 
gent odor. It is one of the natural acids of the stomach, 



INORGANIC ACIDS. 107 

and acts as a tonic on the glands of the alimentary 
canal, increasing the normal secretions. Its astringent 
properties are not marked. In concentrated form it is 
a corrosive poison, not as powerful as nitric or sulphuric 
acids. The symptoms and treatment are like the other 
two. 

Acidum Hydrochloricum Dilutum. 

Diluted Hydrochloric Acid. 

Has a strength of 10 per cent, by weight. 
Dose, nj, x.-xx. (tt[ x. = gtt. x.), well diluted and 
given after meals. (0.65-1.3 Cc.) 

Acidum Nitro-Hydrochloricum. 
Nitro-Hydrochloric Acid. 

Made by mixing 180 parts of nitric with 820 parts of 
hydrochloric acid. An orange-colored liquid, chang- 
ing color in time, and more rapidly on exposure to 
light, to a light yellow. In medicinal doses the physio- 
logical effects are: stimulation of the liver especially, 
and also of the other glands of the alimentary canal. 
Besides being given internally, it is used in local appli- 
cations over the liver, and in baths. In the former case, 
for stupes, the strength is 3 i.-iii. to O. i. of water; and 
in the latter, 3 i. to C. i. In poisonous doses the effects 
are the same as the other mineral acids. The stains it 
produces are yellow. The same antidotes are used as 
given before. 

In giving any of the mineral acids, the first S3^mp- 
toms of intolerance are: griping pains and diarrhoea, 
with strongly acid urine. These points are to be re- 
membered, as well as the necessity for protecting the 
teeth. 

Acidum Nitro-Hydrochloricum Dilutum. 
Diluted Nitro-Hydrochloric Acid. 

Dose, tt[ ii.-x. (rn, x. = gtt. x.), well diluted and 
given through a glass tube. (0.12-0.65 Cc.) 



108 MATERIA ME DIC A FOR NURSES. 

Acidum Phosphoricum (Phosphoric Acid). 

A colorless, odorless liquid, made by boiling phos- 
phorus with nitric acid and water, and having a strength 
of 85 per cent. It is very acid, but does not corrode 
the tissues. Its physiological effects are unimportant 
—mildly tonic and astringent. 

Acidum Phosphoricum Dilutum. 
Diluted Phosphoric Acid. 

Dose, 1U xv.-3ss. (tti x. = gtt. x.), well diluted. 
(1-2 Cc.) 

Acidum Sulphurosum (Sulphurous Acid). 

Made by heating sulphuric acid with charcoal. Sul- 
phurous-acid gas results, and is dissolved in water, 
constituting 6 per cent, of the solution. A colorless 
liquid with pungent sulphurous odor. Sulphurous-acid 
gas 6.4 per cent, is obtained by the combustion of roll 
sulphur, and is used in disinfecting rooms. Before the 
day of microscopical study this disinfection was be- 
lieved to be complete; but it is now known to have very 
little value where pathogenic bacteria are concerned. 
To be at all efficient it must be combined with steam. 
In Germany, sulphur fumigation after contagious dis- 
eases has been entirely discarded. It is, however, of 
real value in ridding a room or ward of bed-bugs, if 
these pests have lodged in the walls or woodwork, and 
for this purpose steam is not necessary. It is a specific 
for all forms of lower animal life — not bacteria. 

Acidum Boricum (Boric Acid). 

Made by the action of sulphuric acid on borax, or by 
purification of native boric acid, which is a compound 
of the element boron with oxygen, and is obtained from 
certain mineral springs in Italy. White, pearly, glis- 
tening crystals, soluble in 25 parts of cold and 3 parts 



THE ORGANIC ACIDS. IO9 

of hot water. The saturated solution has a strength 
of 4 per cent. 

Physiological Actions. 

Boric acid is antiseptic, disinfectant, and deodo- 
rant, destroying low organisms, and stopping fermen- 
tation and putrefactive changes. 

It is not irritating externally, but rather the reverse, 
and when applied to wounds prevents suppuration. 
Internally, in large doses, it is a gastro-intestinal 
irritant, and poisoning has been caused by washing 
out internal cavities with a 5 per cent, solution. The 
symptoms were: nausea, vomiting, hiccough, disturbed 
respirations, rapid ; feeble pulse ; erythema and ecchy- 
mosis, subnormal temperature, and collapse. As a 
wash for babies' eyes and mouths, the saturated solu- 
tion is diluted one half with water. 

It is used as the basis of a variety of mouth washes 
for the sick. It constitutes the largest part of Thiersch 
powder, used in making an antiseptic solution. (See 
salicylic acid.) Its use as a preservative for milk is 
dangerous, the milk so preserved being injurious, 
especially to infants. 

Unguentum Acidi Borici. 
Ointment of Boric Acid. 

Contains paraffin, white petrolatum, and boric acid. 

THE ORGANIC ACIDS. 
Acidum Aceticum (Acetic Acid). 

Prepared from wood by destructive distillation and 
purification. A colorless liquid, with pungent odor 
and strong acid taste; strength 36 per cent.; the rest 
water. 

Glacial acetic acid has 99 parts acetic acid to 1 of 
water, and ctystallizes at a temperature below 6o°. It 
is not official. 



HO MATERIA MEDIC A FOR NURSES. 

Acidum Aceticum Dilutum. 
Diluted Acetic Acid. 



Has a strength of 6 per cent. 



Acetum. 
Vinegar. 

An organic liquid containing acetic acid. It corre- 
sponds nearly in strength with the dilute acid. Vine- 
gar is obtained from various vegetables and fruits by a 
process of fermentation known as the acetous or sour, 
as distinguished from the vinous fermentation and 
others. 

Acetous fermentation may be induced in all liquids 
capable of undergoing vinous fermentation. 

The best vinegar is made from cider. It is often 
adulterated with sulphuric acid. 

Locally used acetic acid is a caustic. It is best ap- 
plied with a glass rod or a splinter of wood, and needs 
to be applied with care to avoid injuring the surround- 
ing parts. 

Diluted and applied to the skin it is stimulant, as- 
tringent, and refrigerant, and in the form of vinegar 
is sometimes added to baths for the reduction of 
temperature. 

Internally it has a stimulating effect on the appetite 
and digestion; increases the secretion from the intes- 
tines, and the flow of urine. It does not neutralize the 
alkalinity of the blood, but decomposes there, and 
combines with part of the alkali of the plasma, forming 
a carbonate, and in this form passes out of the body, 
unless given in excess, when the excess escapes un- 
changed from the kidneys. In the alimentary canal 
the acid acts directly on its contents, and is given in 
the form of vinegar as an antidote for poisoning by 
alkalies. 

In concentrated doses acetic acid is a corrosive 
poison, and has caused death in one case known. 



THE ORGANIC ACIDS. Ill 

The symptoms are like those of the mineral acids, 
and the treatment is the same, consisting in giving 
alkalies and their carbonates, warm soap-suds, and 
milk. 

Acidum Citricum (Citric Acid). 

Citric acid is obtained from the juice of the lemon, 
Citrus limonum, or of the lime, Citrus bergamia, by 
neutralizing the boiling juice with chalk, and putting 
it through various processes. It is very soluble in 
water, and gr. xx, in 3 ss. of water makes a solution 
resembling lemon juice in strength and acidity. 

Citric acid, like the other free acids, acts directly on 
the contents of the alimentary canal, neutralizing 
alkalies. 

It is stimulant ; relieves thirst and promotes appe- 
tite; increases the flow of the saliva and of the gastric 
juice, and, indirectly, increases the action of the kid- 
neys and skin, hot lemonade especially being a 
diaphoretic. 

It is slightly laxative, and counteracts a tendency 
to torpidity of the liver. The juice of half a lemon, 
mixed with that of an orange, is a satisfactory laxative 
drink in many cases. It is best taken before breakfast. 

In malarial countries lemon-juice is freely used as an 
article of food, and among sailors and soldiers it is used 
as a prophylactic against scurvy. 

Citric acid has no action on the sound skin; it is but 
slightly irritating in large quantities internally, and is 
not poisonous. 

It may not be out of place here to refer to a popular 
error regarding a point of diet: that is, that a nursing 
woman may not drink lemonade because it will " sour 
the milk," and " give the baby colic." A nurse will 
probably often be appealed to on this subject. Her 
knowledge of the chemical facts — that citric acid is 
decomposed in the blood, forming a neutral salt; that 
it does not reach the tissues as an acid, but passes out 
of the body as a carbonate — will at once decide the 
question. 



112 MATERIA MEDIC A FOR NURSES. 

Acidum Tartaricum (Tartaric Acid). 

Tartaric acid is the acid of the grape, and is made 
from acid tartrate of potassium by a process similar to 
that used with citric acid. 

Its local action upon abraded surfaces, mucous mem- 
branes, or even the unbroken skin, is that of a decided 
irritant. Taken internally it is diuretic and slightly 
laxative, and somewhat depressing to the heart. 

Tartaric acid does not enter the tissues as an acid, 
but is decomposed in the blood, and passes out of the 
body as a carbonate. 

Poisoning and Antidotes. 

In large doses it is an irritant poison, causing burn- 
ing pain of the oesophagus and stomach, vomiting, and 
gastro-intestinal inflammation, which may prove fatal. 
A dose of J i. has caused death in nine days. The 
alkalies, magnesia, lime, soap-suds, or the alkaline 
carbonates are antidotes. 

Dose, gr. x.-xx., freely diluted. (0.65-1.3 Gm.) 

Acidum Tannicum (Tannic Acid). 

There are two kinds of tannic acid, of which the 
official one is the gallo-tannic, and is obtained by treat- 
ing powdered galls with washed ether. (Galls are 
growths of plant tissue caused by parasitic fungi or 
insects, whose excretions stimulate the plant cells to 
an abnormal development. There are many hundred 
varieties; that from which tannic acid is made being 
formed on an oak tree, Quercus lusitanica, by the action 
of the fly Cynips gallce tindorice.) Tannic acid is a 
light, feathery, yellow-white, non-crystalline powder, 
of faint odor and slightly bitter taste. 

Physiological Actions. 

Locally applied it is an active astringent, contract- 
ing the tissues, and in the case of mucous membranes 
causing great dryness. It coagulates albumin readily. 



THE ORGANIC ACIDS. 113 

It has much greater strength than gallic acid. It is 
used to overcome relaxed conditions, and to check ex- 
cessive secretions of the skin and mucous membranes. 
Parts exposed to friction, as 1 tender feet or sore nipples, 
may be successfully hardened by the use of tannic acid. 
It is also a haemostatic. 

It is the best chemical antidote for the poisonous 
alkaloids, but its administration should be followed by 
emetics and purgatives, as the compounds formed are 
capable of being dissolved and absorbed in the alimen- 
tary canal. 

When meant to act on the stomach it is usually 
given in powder; on the bowels, in pill form; and 
locally, as an ointment or lotion. 

Tannic or gallic acid in some form is contained in 
and gives character to nearly all of the vegetable astrin- 
gents, such as castanea or chestnut, catechu, geranium, 
pomegranate, logwood, hamamelis or witch hazel, 
kino, coto bark, alder, diospyros or persimmon, mango, 
Pinus canadensis, and others. 

Preparations. 

Glyceritum Acidi Tannici. 
Glycerite of Tannic Acid. 

Strength, 20 </<>. 

Unguentum Acidi Tannici. 
Tannic Acid Ointment. 

Strength, 20 <?<>. 

Trochisci Acidi Tannici. 
Tannic Acid Troches. 
1 or. each. 



&' 



Acidum Gallicum (Gallic Acid). 

Gallic acid is also made from galls, and is an astrin- 
gent similar to, but milder than, tannic acid. It does 
not coagulate albumin. 

It is given in powder and pill, in doses of from 10- 
30 gr. (0.65-2. Gm.) 



114 MATERIA ME DIC A FOR NURSES. 

Acidum Lacticum (Lactic Acid). 

I,actic acid is found in sour milk. It is also produced 
by the action of a special ferment on sugar, and is one 
of the normal constituents of the gastric juice. It is a 
pale-yellow, syrupy, inodorous liquid, with acid taste. 

Iyactic acid aids digestion and promotes appetite. 
It is credited with the power of dissolving fibrinous 
exudations, but its use as an application is very pain- 
ful. Flatulence and epigastric pain result from its too 
free administration. 

It enters the blood as alkaline lactates, is decomposed, 
and excreted by the urine as carbonic acid. 

Acidum Lacticum Dilutum. 
Dilute Lactic Acid. 

Consists of 15 parts acid to 85 parts water. Dose 
1 ss.-ii., well diluted. 

Acidum Hydrocyanicum. 
Hydrocyanic or Prussic Acid. 

The pure anhydrous ' acid is a colorless, transparent, 
volatile, and inflammable liquid, so poisonous that its 
fumes alone will cause death. 

Its discoverer, Scheele, is supposed to have died from 
inhaling it. It is not official, and is kept only in 
laboratories. It is found in nature in a number of 
vegetable substances, viz., peach kernels, bitter al- 
monds, wild cherry, cherry laurel, etc. 

Acidum Hydrocyanicum Dilutum. 
Diluted Hydrocyanic Acid. 

Made by distilling aqueous solutions of ferro-cyanide 
of potassium and sulphuric acid, and diluting the pro- 
duct with the water to the required strength. A color- 
less, watery liquid, containing 2 parts of the pure acid 

1 Without water. 



THE ORGANIC ACIDS. 115 

to 98 parts alcohol and water. Its reaction is faintly 
acid; the taste and odor like those of peach kernels and 
bitter almonds. Under the influence of light it has a 
tendency to decompose, and should be kept in dark- 
colored, well-stoppered bottles. 

Physiological Actions. 

Applied to the skin the acid depresses the sensory 
nerves and causes numbness. It is therefore used for 
various local purposes, largely diluted, but should never 
be applied to an abraded surface as, being readily 
absorbed, poisoning might result. 

It enters the blood very rapidly, especially through 
the lungs, enters the tissues promptly, and acts chiefly 
on the nervous structures as a sedative and depres- 
sant. The respiratory centre is especially affected, the 
respirations weakened and slowed. The vaso-motor 
centre is stimulated temporarily, and then quickly de- 
pressed. The cardiac centre is also depressed, though 
it is the last to be affected. The sedative action of the 
drug is not confined altogether to the nerve-centres, but 
is shown also on the muscular structure of the heart. 
The motor nerves and muscles are weakened by hydro- 
cyanic acid, the enfeebling action extending downward. 

It is very rapidly eliminated from the system, prob- 
ably by the lungs. This is not, however, a settled 
point. When taken in medicinal doses hydrocyanic 
acid causes a feeling of sleepiness. The first peculiar 
effects are: a bitter taste, an increased flow of saliva, 
and a feeling of irritation and constriction of the throat. 
These effects pass off iu half an hour or, at most, an 
hour. 

When the dose is rather larger than medicinal, viz., 
about TTt xxx. of the weak acid, there may be noticed: 
nausea, transient giddiness, faintness, a feeble pulse, 
and general muscular weakness. Sometimes there is 
vomiting, or foaming and frothing at the mouth, with 
a suffused or bloated appearance of the face, and promi- 
nent eyes. 



Il6 MATERIA MEDIC A FOR NURSES. 

Symptoms of Poisoning. 

The inhalation of the vapor, short of a fatal quantity, 
causes giddiness, faintness, embarrassed breathing, a 
weak, small pulse, and even coma and insensibility, 
followed by recovery. 

If death results from small doses, there are commonly 
present tetanic spasms, lockjaw, and involuntary evac- 
uations. 

Prussic acid is one of the most powerful poisons 
known, and after a toxic dose the symptoms come on 
instantly, and death may result in a few moments. 
Among its most marked effects are the insensibility 
and loss of muscular power, which are produced much 
more rapidly than by any other poison. 

There is usually loss of consciousness in a few 
seconds; the eyes are protruding and shining, the 
pupils dilated and irresponsive to light; the limbs re- 
laxed and covered with clammy sweat; the pulse im- 
perceptible ; respiration very slow and convulsive, 
sometimes stertorous, sometimes gasping, or sobbing, 
the act of expiration being long and forced, with a 
pause afterwards during which the patient seems dead. 

There is usually an odor of the acid on the breath. 
When the poisonous dose is small, yet still fatal, there 
are often convulsions, spasmodic clinching of the 
fingers, and contraction of the toes. 

The smallest fatal dose recorded was an amount 
equivalent to gr. T 9 o of pure acid. This caused death 
in twenty minutes. Probably the average fatal dose is 
about gr. i. of pure acid, and the average time of death 
from two to ten minutes. It is not an accumulative 
poison. 

Treatment of Poisoning. 

There is no chemical antidote which acts quickly 
enough to be of any service. Cold-water affusions to 
the head and spine, and artificial respirations, are of 
more service than anything else, and should be per- 
severed in, especially the latter, as long as there is any 



THE ORGANIC ACIDS. WJ 

sign of breathing; as, if the tendency to death from 
apuoea be combated until the influence of the poison 
begins to pass off, life may be saved. The stomach 
may be emptied by emetics or the stomach-pump; in- 
halations of ammonia and chlorine water given; and 
injections hypodermically of ammonia, ether, and alco- 
holic stimulants. 

Doseof dilute acid, TTt i.-iii. (ttj, i. = gtt. i.). (0.06- 
0.2 Cc.) 

Acidum Oxalicum (Oxalic Acid). 

Oxalic acid is never used in medicine, but, as a 
poison, it has caused accidental death so often that it 
will be included here. There are two forms of oxalic 
acid: one, the simple acid, which is found in sorrel and 
several other vegetable substances; the other, the 
article known as essential salt of lemon, one of the 
most violent of the corrosive poisons, and often mis- 
taken for Epsom salt. 

Symptoms of Poisoning. 

A hot, acrid taste, and burning in the throat and 
stomach; intense abdominal pain, and vomiting of 
greenish, brown, or bloody mucus of very acid reaction; 
livid, cold skin; small, irregular pulse ; unconscious- 
ness, stupor, and collapse. In some cases the gastric 
symptoms predominate, in others the nervous symp- 
toms, as convulsions, numbness, paralysis, and stupor. 

The smallest fatal dose known is 3 i. An ounce 
usually proves fatal, and the symptoms appear imme- 
diately. Death may occur within a few minutes, or 
may be delayed more than a week, and then take place 
from starvation resulting from the injuries to the in- 
testinal canal. 

Treatment of Poisoning. 

The immediate administration of an antidote is of 
the greatest importance. Neither potash nor soda can 
be used, as their oxalates are poisonous; but lime and 



Il8 MATERIA MEDIC A FOR NURSES. 

chalk are perfect antidotes, and can be given as pre- 
cipitated chalk or saccharated solution of lime, or they 
may be scraped off the wall, whitewashed fences, or 
ceilings, stirred up in milk, and freely administered. 
Emetics, followed by the soothing and demulcent 
drinks usual in the after-treatment of irritant poisons, 
are employed, and stimulants, with external warmth. 
Dr. H. A. Kelly, of the Johns Hopkins Hospital, 
claims that permanganate of potassium and oxalic acid 
afford the only known method of perfectly disinfecting 
the hands of the surgeon, and that in this process the 
oxalic acid is the essential disinfecting agent, the potas- 
sium permanganate being an indicator of the length of 
time the oxalic acid should be left on the hands. 

THE CARBON COMPOUNDS. 

Alcohol. 

Alcohol is a product which results from a process of 
fermentation in substances containing grape-sugar — 
called the vinous fermentation in distinction from the 
acetous or vinegar- forming process. 

At a temperature of 8o° F. , the presence and growth 
of the fermenting body (a low vegetable organism 
called the yeast-plant) converts a solution of grape- 
sugar into alcohol and carbonic acid. Starchy sub- 
stances yield alcohol, starch being convertible into 
grape-sugar. From these vinous or fermented liquors 
alcohol is obtained by repeated distillation. It is also 
made synthetically, 1 .by shaking olefiant gas (a gas 
composed of carbon and hydrogen, which is generally 
present in coal gas, oil gas, and other gaseous mixtures 
produced by the action of heat on organic substances) 
with strong sulphuric acid, diluting and distilling. 
Alcohol is a colorless, volatile liquid, of strong pungent 
odor and burning taste; it is inflammable, burning 
without smoke and with a blue flame, evaporates on 

1 By uniting elements into a compound. 



THE CARBON COMPOUNDS. 1 1 9 

exposure to the air, is vaporized by heat, and unites 
readily with water in all proportions. 

There are three important alcohols or varieties of 
alcohol, viz.: 

i. Alcohol Ethylicum, Ethyl Hydrate, Grain 
Spirit. This is the alcohol of common language. 

2. Alcohol Amylicum, Amyl Hydrate, Potato 
Spirit, called fusel oil, and obtained also as an impurity 
in the production of ethylic alcohol by continuing the 
distillation after the pure spirit has ceased to come 
away. Amylic alcohol is not inflammable. 

3. Alcohol Methylicum, Methyl Hydrate, Wood 
Spirit. Wood spirit is inflammable, and is cheaper 
than alcohol. 

Methyl alcohol is slowly fatal if administered in 
small doses for a long time, or rapidly fatal if taken in 
large doses at one time, and causes optic-nerve atrophy 
— " methyl alcohol blindness. " Its use in the manu- 
facture of many essences, Jamaica ginger, soda water, 
ales, etc., and its use in the form of " Columbian 
spirit," witch hazel, bay rum, eau de cologne, peruna, 
etc., is common and is to be condemned. 

Liquor Formaldehydi. 
Solution of Formaldehyde. 
Formaline. 

Formaldehyde is derived from the oxidation of wood 
alcohol. It is antiseptic, disinfectant, deodorant, and 
germicidal in its action. It may be used either in 
solution in water (formaline) or as a vapor. Its action 
seems to be specific for the destruction of lower animal 
and plant life, but not for the higher animals. Sul- 
phur is a better germicide for insects than formaldehyde, 
and the action of the latter is simply irritant to human 
beings. Formaldehyde is as efficient as corrosive sub- 
limate and penetrates more rapidly. It is too irritating 
as an antiseptic in general surgery, but may be used in 
solutions of 1 : 500 or 1000. Instruments can be sterilized 
in a solution of 1:200 formaline. It may be employed 
as a deodorant, and as a • disinfectant for stools and 



120 MATERIA MEDICA FOR NURSES, 

sputa in 5 $ solution. A solution of i : 50 may be used 
for sweating feet. Clothing may be thoroughly disin- 
fected by placing the articles in a compartment, causing 
a vacuum, and distilling the gas into this compartment 
where it penetrates thoroughly into every article. In 
the disinfection of rooms the gas should be admitted 
under pressure through the keyhole, after the room 
has been made practically air-tight. The gas from 
150 c.c. of 40 <f formaline is sufficient for each 1000 
cubic feet of space. The room should be closed for 
twenty-four hours and before entering it a small amount 
of ammonia may be sprayed into the room to precipi- 
tate the formaldehyde, thus preventing the extremely 
irritant effects on the eyes and mucous membranes, 
when the room is entered. 

The use of formaldehyde as an intravascular anti- 
septic has been a failure. It has been used as a 
respiratory disinfectant. 

Poisoning is very rarely reported. Large amounts 
internally or as douches cause toxaemia by shrivelling 
up the red blood cells, with the formation of haematin. 
There may be vomiting, purging, dyspnoea, cyanosis, 
and collapse. Ammonia water is the antidote. 

Physiological Actions. 

The action of alcohol is both local and general. It 
is an irritant in either case; an irritant being a drug 
that disorders or disorganizes function, in contradis- 
tinction to a stimulant, which increases activity, 
thereby increasing function. Its local action is the 
more important, for its entire effect may be due to the 
local irritant action on the skin and mucous membrane, 
and after absorption on the endothelium of the blood- 
vessels or their intrinsic nervous apparatus, on the 
heart and skeletal muscles, on the brain and nervous 
system, on the organs, and on all the cellular elements 
of the body. It produces at first a disorderly reaction 
by its irritant effect, finally causing fatigue, or com- 
plete inactivity of all parts by depression, depending 
upon the amount taken and the condition of the indi- 



THE CARBON COMPOUNDS. 121 

vidual, etc. As in the case of any other poison there is 
a certain reaction in the organs and their functions in 
attempting to get rid of the noxious element. Alco- 
hol has great affinity for nervous tissue. The brain 
responds by losing its power of inhibition, thus allow- 
ing free play to the emotions, while lessening will 
power. At first there is a quicker response to stimuli, 
but finally less capacity for accurate work either 
mental or physical. The respirations are increased in 
frequency, the alcohol being oxidized rapidty, and 
eliminated. The heart becomes more active and force- 
ful as a result of the dilatation of the peripheral blood- 
vessels, due to paralysis of the vaso-constrictors, de- 
creasing the resistance to the action of the heart, and 
by paralysis of the cardiac inhibitory nerves, thus giv- 
ing the cardiac acceleration full play. Small quantities 
of alcohol after meals may improve the digestion by 
irritating the mucous membrane to greater activity, 
but prolonged regular use, or large quantities taken at 
one time, especially on an empty stomach, create grave 
indigestion by causing a catarrhal condition of the 
mucous membranes. Muscular activity is increased, 
for a few minutes, but in a disorderly way, and is 
rapidly followed by fatigue. Experiments prove that 
alcohol in even minute quantities is detrimental to rifle- 
men at target practice, tight-rope performers in their 
acts, and whenever fine adjustments of nerve and 
muscle are necessary. Likewise it has been found to 
be harmful to mountain climbers, who are unable to 
carry on their feats of skill and endurance, to soldiers 
on the march, and to labor in all conditions. Theo- 
retically alcohol is a food, saving tissue waste by 
taking the place of fats and carbohydrates in the pro- 
duction of heat and energy, but practically it is of no 
value. It is not a serviceable food, but an oxidizable 
drug, and may require more energy to overcome its 
irritant effects than it creates by stimulating, if it does 
really stimulate. Alcohol acts peculiarly by lowering 
body temperature and vitality, thus inviting inroads 
by any or all diseases that may be prevalent, or with 



122 MATERIA MEDIC A FOR NURSES. 

which the person may come into contact. Its poison- 
ous properties are thus manifested, and European 
studies have proved beyond a doubt that it is detri- 
mental. It is absolutely bad for children and nervous 
persons. 

In morbid states alcohol may be of service, as to tide 
over a crisis in fever, but it should never be used in 
case of shock, or during anaesthesia, because better 
remedies may be applied. 

Alcohol is locally antiseptic and disinfectant, 
cooling, and astringent. Internally, in medicinal 
doses it is pre-eminently a heart stimulant, and, in 
a lesser degree, a diuretic, diaphoretic, and anti- 
pyretic. 

When rubbed into the skin, as for the prevention of 
bed-sores, it disinfects and hardens it, checks the 
activity of the sweat glands, and irritates the cutaneous 
nerves, causing redness, heat, and local anaesthesia. 
Applied and allowed to evaporate, as in sponge baths, 
it has a cooling action. Coming in contact with an 
abraded surface it is very painful. It is absorbed by 
the unbroken skin. In the stomach it produces a sense 
of warmth, and, in moderate amount, stimulates the 
mucous membrane and dilates the small vessels, with 
the result that the blood supply is increased and the 
gastric secretion is correspondingly abundant. 

When used in doses sufficient to give this result 
simply, alcohol is evidently favorable to digestion, but 
in larger quantities it has another and unfavorable 
action, namely, that of precipitating the pepsin of the 
stomach. 

Overdoses produce this result ; a small quantity, 
diluted as it is by the gastric fluids, has not sufficient 
power to act on the pepsin to any marked degree. If 
alcohol is constantly used to excess, an abnormal 
secretion of mucus — gastric catarrh — results, with 
various evidences of dyspepsia, viz. : loss of appetite, 
acidity of stomach, heartburn and pyrosis, nausea, and 
morning vomiting. 

Other evidences of the alcohol habit are: constipa- 



THE CARBON COMPOUNDS. 123 

tion; pain on pressure over the stomach; brown, dry 
tongue with red tip; chronic pharyngitis; fat, flabby, 
soft hands. 

Sleep, for the first part of the night, is sound, but is 
disturbed in the early morning, after which wakefulness 
remains, or broken sleep with bad dreams. 

Confirmed drinkers age fast. The skin becomes dry, 
and feels waxy, soft, and unhealthy. The mind be- 
comes sluggish and weak, and cirrhosis of the liver and 
kidneys, phthisis, epilepsy, paraplegia, insanity, and 
other disorders are among the sequels of alcoholism. 

Alcohol enters the blood unchanged or as aldehyde, 1 
and reaches the tissues and organs, a small portion 
being changed into acetic and carbonic acids. In its 
passage through the tissues it is oxidized, if given in 
moderate amount, and changed into carbonic acid and 
water, like other carbo-hydrates, — thus becoming a 
food or source of heat and force. 

In a healthy adult, § iss. of absolute alcohol can be 
thus oxydized in twenty-four hours, and supplies to the 
organism as much heat and energy as is contained in 
the same amount of cod-liver oil or in about | ix. of 
beef. 

Beyond this, in health, it becomes injurious, and is 
eliminated by the kidneys, skin, and lungs; though in 
different morbid states large — even excessive — quanti- 
ties can be safely taken. 

Although alcohol is itself oxydized, it interferes with 
the oxidation of other substances, thus saving the tis- 
sues from wear and retarding the process of waste. 

This, joined to its apparent stimulating action on 
the circulation and on the nervous system, gives it the 
power of sustaining life for a time, under the strain of 
acute exhausting disease, or during a period of tem- 
porary inability to take sufficient food. 

Its apparently stimulant effect is shown on the heart 
by an increase in the strength of the contraction or 
systole. The pulse becomes strong and regular, full, 

1 Alcohol deprived of a certain proportion of its hydrogen. 



124 MATERIA MEDIC A FOR NURSES. 

and compressible. If it had, before, been rapid and 
weak, it will, under the favorable influence of alcohol, 
become reduced in frequency to near the normal; but, 
if over-stimulated, this shortening of the period of rest 
will in time exhaust the heart. 

In giving alcohol as a medicine, it is important to be 
able to recognize the first evidences of over-stimulation 
as given by the pulse. 

The ' ' whisky pulse, " as it is called, is unnaturally 
strong, full, frequent, and bounding. 

On the brain and nervous system alcohol acts as a 
stimulant, up to a certain point; beyond that, as a 
depressant and narcotic. 

On the circulation and bodily heat its action would, 
at first sight, seem to be contradictory. The sense of 
warmth given by a dose of alcohol seems incompatible 
with the well-proved facts that the bodily heat is, on 
the whole, lowered by alcohol, and that the power of 
resistance to cold is weakened by its use. 

The physiological explanation is, that the blood-ves- 
sels are dilated by paralysis of the vaso-constrictors, — 
the blood rushes to the surface to fill the superficial ves- 
sels, and a feeling of warmth results, which, in a warm 
or moderately cool atmosphere, remains, and promotes 
the general comfort; but, in a cold atmosphere, the 
supply of blood to the surface being so much larger 
than ordinary and perspiration being also increased, 
while active tissue-changes are checked, heat is ab- 
stracted from the body by evaporation at a rate which 
soon affects the vital powers seriously. 

In giving stimulants there are various points to 
notice by which to judge whether it is doing good or 
not. 

The pulse has been mentioned; the tongue gives 
another indication. If a dry tongue becomes moist 
under the influence of alcohol, it is acting well; if the 
dryness of the tongue be increased, it is not, and 
the same rule applies to the skin. If nervousness is 
quieted, sleep induced, delirium and subsultus lessened 
by alcohol, it is acting favorably; if restlessness and 



THE CARBON COMPOUNDS. 1 25 

uneasiness follow, or increased delirium, or sleepless- 
ness, — unfavorably. 

In cases of sudden heart failure alcoholic stimulants 
are given hot and concentrated. 

Dilute alcohol administered early is a valuable anti- 
dote in carbolic acid poisoning. 



Symptoms of Poisoning. 

A steady course of alcohol in excess, without taking 
food, will result in delirium tremens. Acute alcoholic 
poisoning presents the following symptoms: a short 
period of excitement, followed by coma; respirations 
irregular, sometimes sighing but usually stertorous; 
pupils either dilated or contracted, usually the former; 
face flushed; pulse hard, rapid, and strong. 

Acute alcoholic poisoning may be mistaken for opium 
poisoning, apoplexy, or compression of the brain. 

Death results from paralysis of the heart and respira- 
tions. The time at which death may occur varies from 
•a few minutes to several days. 

The smallest known fatal dose was between 1 iii.-iv. 
of brandy swallowed by a child of seven. One pint or 
200 Cc. of whisky at one time is a fatal dose. 

Treatment of Poisoning. 

The treatment consists in emptying the stomach; the 
application of heat to the extremities and cold affusions 
to the head; the inhalation of ammonia, and the use 
of electricity applied to the respiratory muscles. 



Preparations of Alcohol. 

Alcohol. 
Alcohol. 

Contains 94.9$ by volume, 92.3$ by weight, of 
pure ethyl alcohol with 7.7 of water. 



126 MATERIA MEDIC A FOR NURSES. 

Alcohol Absolutum. 
Absolute Alcohol. 

Made from alcohol by a lengthy chemical process. 
It consists of 99 parts pure alcohol with i of water, and 
is not kept for sale but used only for pharmaceutical 
purposes. 

Spiritus Tenuior. 
Proof Spirit. 

Equal parts of alcohol and water, or, strictly speak- 
ing, 49 per cent, alcohol. 

Alcohol Dilutum. 
Dilute Alcohol. 

41 % by weight, of alcohol, 48.6 $ by volume. 
Alcoholic Beverages. 

Spiritus Frumenti. 
Whisky. 

Made in the United States from rye and corn, in 
Scotland from barle}', and in Ireland from potatoes. 

It has from 44 to 50 per cent, by weight of ethyl alco- 
hol (by volume 50 to 56 per cent.), and contains ethers 
which are developed in the course of its fermentation; 
and, even in the best varieties, some traces of fusel oil. 
Whisky should be at least two years old before it is 
used. 

It is sometimes necessary or convenient to use alcohol 
instead of whisky. The ordinary dose of § ss. whisky 
is represented by a little over 3 ii. of alcohol, or by § ss. 
of dilute alcohol. 

Spiritus Vini Gallici. 
Brandy. 

Brandy should be distilled from grapes, but it is also 
made artificially. It has about the same percentage of 
alcohol as whisky. It may be either pale or dark; in 



THE CARBON COMPOUNDS. 1 27 

the former case it is colored by the cask, in the latter it 
contains caramel. It should he at least four years old. 
Brandy has a more sedative action on the stomach than 
whisky, and is preferable where there is any tendency 
to diarrhoea, as it is slightly constipating, containing 
a little tannin. Both brandy and whisky are more 
easily taken, as medicines, if poured over a small glass- 
ful of cracked ice; or they may be diluted with carbon- 
ated or seltzer water more acceptably than with plain 
water. Giving them in milk very often causes patients 
to take a dislike to the milk. They are both used 
hypodermically, and for this purpose should always be 
filtered. 

Rum. 

Made by the distillation of fermented molasses. 

Gin. 

Distilled from rye or barley, and flavored with juni- 
per berries. If it is pure it is an efficient diuretic, 
owing to the oil of juniper, but it is rarely pure. 

Wines. 

Official wines are white wine, vinum album, and red 
wine, vinum rubrum. They are used in medicinal 
preparations. White wine contains about 10 per cent, 
of alcohol, and is made from grape juice without skins, 
stems, or seeds. 

All wines contain various acids and traces of mineral 
substances. Those which are free from sugar are called 
14 dry " wines. 

The red wines — claret, port, etc. — are made from 
colored grapes with the skins, and have considerable 
alcoholic strength. Port wine, vinum portense, con- 
tains from 30 to 40 per cent, of alcohol, but is rarely 
pure. 

As stimulants and in narcotic power these wines 
stand next to brandy and whisky. They contain some 
tannic acid and are astringent, causing constipation 



128 MATERIA MEDIC A FOR NURSES. 

and disordering the stomach. They also tend to raise 
the temperature. 

Vinum xericum, or sherry, belongs to the dry spirit- 
uous wines. It contains 17 per cent, of alcohol, and is 
usually made artificially. It assists digestion if taken 
during meals. 

Sparkling wines, of which champagne is the most 
important, are bottled before fermentation is complete, 
and are effervescent, being charged with carbonic acid. 
They are more intoxicating than others in proportion 
to their strength, are less stimulating to the heart, 
and liable to leave headache and sour stomach as after- 
effects when freely taken. In small doses they are 
gastric sedatives, champagne especially being so. 
Given ice-cold and in teaspoonful doses, at short inter- 
vals, it may be retained by an irritable stomach which 
rejects everything else. In giving champagne in this 
way care is necessary to prevent escape of the gas and 
flattening of the wine. A champagne tap is used, and 
the bottle held head downward. In the intervals it is 
kept on ice in the same position. 

Sweet wines, including Burgundy and Madeira, are 
rather trying to the digestion. They disorder the 
stomach and cause headache. They contain 6 or 7 per 
cent, of alcohol. 

Dry acid wines — the German and some of the French 
wines — are stimulant, and do not cause acid fermenta- 
tion. They contain from 5 to 7 per cent, of alcohol. 

Beer, Ale, Porter, Stout, 

Contain from 2 to 6 percent, of alcohol; also extract 
of malt, lactic acid, salts of potash and of soda, and 
aromatics. 

Chloroformum (Chloroform). 

Chloroform is made by the action of chlorine on 
alcohol. 

Physiological Actions. 

Externally applied and allowed to evaporate, chlo- 
roform causes a sense of coldness and depresses the 



THE CARBON COMPOUNDS. 1 29 

terminations of the sensory nerves, acting as an anodyne 
and producing insensibility to pain. If evaporation is 
prevented it irritates, reddens, and blisters the skin. 
These effects are followed by anaesthesia of the part. 
Given by mouth, chloroform has a hot, sweet taste, 
and in the stomach produces a feeling of warmth. In 
large quantities or undiluted it causes violent gastro- 
enteritis. Medicinally it is given as an antispasmodic, 
anodyne, and carminative. It enters the circulation 
through the lungs, stomach, and unbroken skin. It 
reaches the tissues very rapidly, and exerts its greatest 
power on the central nervous system. It is excreted 
partly as chloroform by the kidneys, lungs, mammary 
glands, and skin, and part is lost in the system. 



Symptoms of Poisoning. 

In poisoning by chloroform taken internally the 
symptoms are: stupor; cold skin covered with perspi- 
ration ; pulse slow, thread}', sometimes almost imper- 
ceptible ; respirations at first stertorous, afterwards 
becoming shallow, irregular, and infrequent. The 
symptoms come on almost immediately after it has 
been swallowed, and death may result in a few hours, 
or may result after a longer time from gastro-enteritis 
or from inflammation of the trachea. 



Treatment of Poisoning. 

There is no antidote for chloroform, on account of its 
extremely rapid diffusibility through the system. The 
stomach must be emptied, washed out, if necessary, 
and cold-water affusions applied to the head, and plenty 
of fresh air admitted. Artificial respiration should be 
practised steadily and unremittingly. 

The smallest fatal dose recorded is 3 ii. 

Dose of chloroform, Til i.-x. ("rq, x. = gtt. lx.). 
(0.03-0.3 Cc.) 
9 



130 MATERIA MEDIC A FOR NURSES. 

Spiritus Chloroformi. 
Spirit of Chloroform. 

Strength, 10 <f . 

Dose, 3 ss.-i., well diluted. (2-4 Cc.) 

Emulsum Chloroformi. 
Emulsion of Chloroform. 

Chloroform, 4 <f . 
Dose, 1 ss. (16 Cc.) 

Chlorodyne. 

A proprietary medicine containing chloroform, ether, 
morphine, cannabis indica, and hydrocyanic acid. 

Dose, ttl v.-xxx. (TTl x. = gtt. xx.), well diluted. 
(0.3-2. Cc.) 

Linimentum Chloroformi. 
Chloroform Liniment. 

Composed of soap liniment and chloroform. 

Linimentum Chloroformi Compositum. 
Compound Chloroform Liniment. 

Contains chloroform, oil of turpentine, laudanum, 
tincture of aconite, and soap liniment. 

Chloroform Anaesthesia. 

In the use of the vapor of chloroform as an anaesthetic 
there are three stages of narcosis: the first, a short 
period of excitement during which the sensibilities are 
blunted, though consciousness is not lost; second, the 
stage of anaesthesia. Consciouness and sensibility are 
abolished; the pulse is about normal in frequency and 
slightly weaker; respiration slow, heavy, and stertor- 
ous. During this period operations are performed. 
The third stage is a dangerous one, with profound 
narcosis; entire muscular relaxation; stertorous breath- 
ing, gradually becoming sighing and weak; and com- 
plete abolition of reflex actions. 



THE CARBON COMPOUNDS. 131 

Choloform is preferred to ether in some cases because 
it is easier and pleasanter to take; is more prompt in 
its action; is not so nauseating, and its after-effects 
pass away more quickly. In obstetrical cases it is 
preferred because by its use a stage of insensibility to 
pain can be produced without bringing on complete 
muscular relaxation, which would delay labor. 

No fatal cases are known to have occurred in par- 
turient women, although in surgical cases death has 
occurred quite frequently and with great suddenness, 
from paralysis of the respirations and heart, and ordi- 
narily chloroform is considered much less safe than 
ether. In giving chloroform to a patient in labor 
(which a nurse may be required to do), the face must 
first be oiled with vaseline to prevent any possibility of 
blistering. 

About 3 ss. of chloroform is poured at one time on a 
sponge, or piece of lint, and held before the nose in 
a way that will allow plenty of air to mix with it, as 
the chloroform should only be in a strength of 3 per 
cent, with the inspired air when inhaled. 

It is only to be inhaled during the existence of a 
pain, and not in sufficient quantity to lessen uterine 
contraction. If the pulse weakens, the respirations 
grow shallow, or the pains become insufficient, it is 
stopped. 

It is well to keep the supply safely out of reach in 
the case of excitable and hysterical patients. 

In the treatment of poisoning by inhalation of chlo- 
roform vapor, the head is lowered to an angle of about 
40 . Plenty of fresh air is needed, and should be 
warm, about 8o°-85° F. External heat must be ap- 
plied, and artificial respiration kept up for several 
hours. 

iEther (Ether). 

Ethyl Oxide. 

A colorless, volatile liquid, made by the action of 
sulphuric acid on alcohol, by a very elaborate process. 



132 MATERIA MEDIC A FOR NURSES. 

It evaporates rapidly on exposure to the air, and is 
very inflammable, as is also the vapor. The odor is 
very strong, heavy, and peculiar. 

Physiological Actions. 

Applied to the skin and allowed to evaporate, ether 
is a refrigerant and local anaesthetic of such power 
that minor surgical operations are sometimes performed 
under its local influence; the part to be operated on — 
as, for instance, a finger — being sprayed with ether 
until benumbed, a process which requires only a few 
moments' time. 

Internally it has a strong burning taste, is irritant 
to mucous membrane, and causes salivation through 
reflex action. In the stomach it acts as a local stimu- 
lant and carminative, and also, by reflex action, as a 
stimulant to the heart, respiratory organs, brain, and 
intestines. 

It is an antispasmodic, anthelmintic, and diapho- 
retic. When inhaled it first produces a strong irrita- 
tion of the throat, with a strangled feeling. The 
cerebrum is first affected by the use of ether as an 
anaesthetic; the sensory and motor nerves next; the 
centres of respiration and circulation in the medulla are 
the last to become influenced, and continue to act, 
unless the anaesthetic is pushed too far, when the res- 
pirations die away, the heart continuing to beat after 
breathing has stopped. Reflexes from nose (fifth nerve) 
and rectum are the last to be abolished. 

The state of the bladder must be carefully watched 
in all cases after etherization, as there is often retention 
of urine. External heat must be plentifully supplied, 
and the facility with which an insensible patient may 
be seriously burned by hot-water bottles and bags 
should be constantly kept in mind. The effects of the 
ether are allowed to pass off quietly of themselves, 
plenty of fresh air being secured, any effort at vomiting 
being best overcome by giving a teaspoonful of very 
hot water at intervals. If there is no tendency towards 
collapse, cracked ice in small quantities may be used. 



THE CARBON COMPOUNDS. 1 33 

In preparing a patient for etherization, definite orders 
from the surgeon are always received, and it is only 
necessary here to speak of the absolute importance of 
having the stomach, bowels, and bladder entirely 
empty. 

Death from strangulation may be caused by a frag- 
ment of vomited food lodging in the windpipe, and the 
bowels and bladder, if not thoroughly attended to, will 
empty themselves spontaneously. 

Ether is excreted like chloroform, and rapidly. The 
anaesthetic mixture of Nussbaum is formed of ether 3 
parts, alcohol and chloroform each 1 part. 

Preparations of Ether. 

Spiritus iEtheris 
Spirit of Ether. 

Has 32.5 parts of ether and 67.5 of alcohol. 
Dose, 3 i., well diluted with cold water. (4 Cc.) 

Spiritus Athens Compositus. 
Compound Spirit of Ether. 
Hoffman's Anodyne. 

Contains 32.5 </<> ether, with alcohol and ethereal oil. 
It is a carminative, antispasmodic, and stimulant. 

Dose, 3 i.— ii. , diluted with very cold or iced water. 
(4-8 Cc.) 

Spiritus iEtheris Nitrosi. 
Spirit of Nitrous Ether. 
Sweet Spirit of Nitre. 

A solution of sodium nitrite in alcohol, with the 
addition of sulphuric acid, monhyd rated sodium car- 
bonate and potassium carbonate. Sweet spirit of nitre 
is volatile and inflammable. It should not be kept 
long, as it becomes acid with age. It is a diuretic and 
diaphoretic, acting by relaxing and dilating the renal 



134 MATERIA MEDIC A FOR NURSES. 

and cutaneous vessels. It is also a nerve sedative 
and antispasmodic. 

The action on the skin is made more prominent by- 
keeping the patient warmly covered in bed, and on 
the kidneys when kept cool, or out of bed. Like all 
preparations of ether it should be largely diluted and 
given very cold, as this lessens the strangling feeling in 
the throat. 

The inhalation of sweet spirit of nitre has caused 
alarming symptoms — viz.: pallor, weak pulse, muscular 
weakness, pain about the heart, and headache. 

Taken internally, in large quantities, it has in one 
or two instances caused death. 

Dose, 3i-i- (i-4Cc.) 

Preparations of ether are given hypodermically as 
heart stimulants, and should be injected deeply into 
the muscular tissues to avoid irritation and formation 
of abscesses. 

iEthylis Bromidum. 
Ethyl Bromide. 
Bromide of Ether. 

Made by distilling together alcohol, sulphuric ether, 
and potassium bromide. It is colorless, volatile, and 
highly inflammable. Ethyl bromide is used as a gen- 
eral anaesthetic in short operations, or before beginning 
chloroform anaesthesia. It is administered by means 
of a mask, as in giving ether. Anaesthesia lasts on an 
average for a minute and a half with one administra- 
tion of the anaesthetic. Consciousness returns more 
quickly than from any other anaesthetic, but the inhala- 
tion is not pleasant and patients complain of great de- 
pression and discomfort afterwards. Ethyl bromide is 
liable to decomposition when kept long and is often 
furnished in impure form. It ought to be perfectly 
colorless, as a yellow color indicates decomposition, 
often with the presence of free bromine. Dose, 31-6 
(4-22 Cc.)., by inhalation from an air-tight cone held 
firmly over the nose and mouth. 



THE CARBON COMPOUNDS. 135 

.^ithylis Chloridum. 
Ethyl Chloride. 
Chloride of Ether. 

Produced by the action of dry hydrochloric acid gas 
on absolute alcohol. A gas at ordinary temperature, 
it may easily be liquefied. It is used both as a general 
and a local anaesthetic. In obstetrics and in dentistry 
it may take the place of chloroform or of nitrous oxide, 
and it may be used preliminary to the administration 
of ether or chloroform. The liquid conies in sealed 
glass tubes with capillary points which are to be broken 
off or unscrewed when the liquid is volatilized by the 
warmth of the hand. The stream is directed upon the 
point desired in local anaesthesia, the tube being held 
a few inches away. Anaesthesia is usually effected in 
fifteen to twenty seconds. It should not be applied so 
long that the tissues are frozen hard, but should be 
removed as soon as they appear white. Too much 
freezing may cause delayed healing or a slough. 

Chloral. 

Chloral is an oily, colorless fluid, made by the action 
of chlorine on alcohol. It is not used in medicine. 
United with water it forms a hydrate which is the 
hydrated chloral of the U. S. P. 

Chloralum Hydratum. 
Hydrated Chloral. 

Colorless, volatile crystals of hot, burning taste and 
pungent odor; readily soluble in water, ether, or alcohol. 

Physiological Actions. 

Chloral has antiseptic properties and has been so 
used in a strength of gr. v.- 3 i. of water. A concen- 
trated solution vesicates and is very painful. 

Given internally it acts on the nerve centres as a 
sedative, its effect on the brain, under suitable condi- 
tions, being that of a pure and perfect hypnotic. The 



I36 MATERIA MEDIC A FOR NURSES. 

sleep it causes resembles natural sleep, coming on 
quickly and lasting for six or seven hours. The 
patient may be aroused from it for medicine or nourish- 
ment, and falls asleep again, finally awaking refreshed 
and without headache or the unpleasant after-effects — 
such as nausea, giddiness, and constipation — which are 
commonly found after taking opium. Even if given 
for a long time chloral is not apt to cause constipation 
or disturbance of the stomach. 

In the sleep of chloral the pupil is slightly con- 
tracted, the pulse unaltered or a little slower than 
normal, the respirations regular, full, and quiet. The 
cases in which its beneficial action is best seen are 
cases of insomnia from mental labor, anxiety, or 
fatigue. It is not an anodyne, having no power to 
overcome pain unless given in dangerous doses. If so 
given the after-effects are bad. 

The action of chloral is not always satisfactory. 
With some persons headache, excitement, and even 
delirium are caused by medicinal doses. It is pre- 
eminently a great depressant. 

Symptoms of Poisoning. 

In larger doses the respiratory centre is depressed 
and the respirations become slow, irregular, and shal- 
low. The activity of the vasomotor centre is lessened, 
so that the vessels dilate generally, and the heart is 
depressed and weakened not only through the centre 
in the medulla but also by a direct influence on its own 
nerve ganglia. 

The pulse becomes weak and slow; in toxic doses it 
grows rapid and irregular, and in fatal cases feeble and 
thready, while other symptoms are coma, great muscu- 
lar relaxation, pupils at first contracted, afterwards 
dilated; and death results from paralysis of the respira- 
tions and heart. 

Treatment of Poisoning. 

The treatment in chloral poisoning consists in the 
use of alcoholic stimulants, strong coffee, galvanism, 



THE CARBON COMPOUNDS. l?>7 

and artificial respiration. The application of external 
heat is of the utmost importance. Mustard pastes and 
hot mustard foot-baths may be used, avoiding, how- 
ever, all measures which might exhaust the patient. 

Incidental Effects. 

There may be noticed after ordinary doses of chloral, 
dyspnoea; redness and swelling of the conjunctivae; and 
eruptions of the skin, most frequently a simple erythema 
which seems to follow preferably the course of the large 
nerve trunks. Sometimes the eruption takes the form 
of wheals, and a papular eruption has also been ob- 
served. These disorders are often attended by some 
rise of temperature, and desquamation sometimes re- 
sults. It is supposed that they, as well as the more 
alarming ill effects of chloral, are greatly, if not alto- 
gether, due to impurities in the drug. 

The great danger of chloral is the sudden paralysis 
of the heart, which may occur even after ordinary 
medicinal doses, and without warning. This attaches 
so much uncertainty to its action that it is impossible 
to express caution too strongly in regard to using it 
without orders. The patient may be sleeping quietly, 
but suddenly becomes restless and passes into a state 
of syncope. The danger cannot be considered past 
until from 60 to 100 pulse beats can be counted con- 
tinuously without any irregularity in strength. 

The habitual use of chloral may become a disorder 
almost as grave as the opium habit. Those who have 
formed this habit are usually excitable in manner; 
hurried and voluble in speech; nervous and wakeful at 
night; melancholy and low-spirited during the day, 
and subject to vertigo and ringing in the ears. The 
eyes are brilliant and restless; the appetite capricious 
or lacking altogether; digestion disordered; the heart 
action weak and irregular; and the secretion of bile 
deficient. 

Dose, gr. v.-xx., diluted only moderately with water 
or a weak syrup. (0.3-1.3 Gm.) 



138 MATERIA MEDIC A FOR NURSES. 

Butyl Chloral Hydrate. 
Croton Chloral. 

A crystalline body formed by the action of chlorine 
on aldehyde; sparingly soluble in water, readily so in 
glycerin. It is said to resemble chloral in its action, 
but to be more depressing and less efficient. A feebler 
poison, more disagreeable in taste, and having a special 
anaesthetic effect on the fifth nerve. 

Dose, gr. v.-xx., in syrup or glycerin. (0.3-1.3 
Gm.) 

Metachloral. 

A solid substance prepared by acting on chloral 
hydrate with sulphuric acid, and used as a counter- 
irritant and local anaesthetic. 

Chloral Camphor. 

Equal parts of camphor and chloral, used as an ex- 
ternal application for the relief of pain. 

Paraldehydum (Paraldehyde). 

Paraldehyde is a colorless liquid solidifying below 
50 F., and soluble in ten parts of water. It has a 
strong ethereal odor and unpleasant taste. It is a 
pure hypnotic, like chloral, having about half its 
power and many of its qualities without the dangers 
of chloral. 

In its action the cerebrum is first affected, and sleep 
induced with no primary stage of excitement. The 
medulla is next affected, and next the spinal cord. It 
has little or no control over pain. In medicinal doses 
it is not paralyzing to the heart, and does not, as a rule, 
leave headache or unpleasant after-effects. 

It is irritant to mucous membrane, and is likely in 
time to impair digestion. It gives an unpleasant odor 
to the breath, and if used for a long time it may produce 
nasal ulcers, cerebral congestion, and vasomotor paraly- 
sis. It sometimes causes erythema or reddening of the 



THE CARBON COMPOUNDS. 1 39 

skin. Dose, tt[ xx.-3i. ("^l x. = gtt. xxv.) (1.3-4. 
Cc), in water, either plain or with simple syrup. It 
must be well diluted. 

Sulphonal. 

Sul phonal is an alcohol derivative, belonging to what 
are chemically known as the sulphur compounds of 
alcohol. It has hypnotic action. It is a white, odor- 
less, and tasteless powder, almost insoluble in water, 
requiring from 100 to 150 parts of cold, and 18 or 20 
of boiling, water to dissolve it. 

In favorable instances it produces a physiological 
sleep, which lasts for several hours, with no unpleasant 
after-effects. With susceptible cases sleep has been 
known to come on in an hour or little over, but as a 
usual thing suphonal is rather slow in action, sometimes 
not taking effect for several hours, sometimes even not 
until the next day; and in these delayed cases, sleep, 
when it does come, is prolonged and dull. In a certain 
number of cases sulphonal fails to act satisfactorily, 
and, in these, nausea, mental excitement, vomiting, 
dizziness and staggering, headache and depression have 
been observed after its use. 

It may be given dry on the tongue, but is best given 
in hot milk, or soup, or beef-tea, with plenty of salt. 
Large amounts of warm fluids favor its absorption, and 
as it is often slow in action it is better given early in 
the evening. Dose, gr. xx.-xxx. (1.3-2. Gm.) 

Hypnone. 

A new hypnotic, produced chemically as a deriva- 
tive of alcohol. A colorless liquid having a strong odor 
of almond or orange. It is not dangerous, and leaves 
no ill after-effects except a disagreeable odor to the 
breath. 

Dose, gr. v.-x. (0.3-0.65 Gm.), in capsule, being in- 
soluble in water. 



140 MATERIA MEDIC A FOR NURSES. 

Urethan. 

A combination of carbonic acid and ethylic ether, 
lately introduced as a hypnotic. Its action is rather 
uncertain, and resembles paraldehyde. It has no 
power over pain, is not depressing or irritating to the 
stomach, and under favorable circumstances has in- 
duced sleep in 15 or 20 minutes, and prolonged it for 6 
or 8 hours. It is soluble in water, and may be given 
hypodermically, as it is not irritating. 

Dose, gr. x.-lx. (0.65-2.6 Gra.), best given in pellet, 
wafer, or capsule. 

Amylene Hydrate. 

An alcohol derivative, with properties as a hypnotic, 
its power being considered intermediate between chloral 
and paraldehyde. It is a clear liquid, soluble in 8 parts 
of water, and readily so in alcohol. It is agreeable to 
the taste and not dangerous, having, in medicinal doses, 
no depressing effect. Very large doses paralyze the 
respiratory centre, and also the heart. 

Dose, 3 i.-iss. (4-6 Gm.) 

Amylis Nitris (Amyl Nitrite). 

Amyl nitrite is produced by distilling nitric acid with 
amylic alcohol (fusel oil), sulphuric acid, and copper, 
and purifying with alkalies by various intricate pro- 
cesses. An ethereal liquid of yellow color and fruity 
odor. 

It is given by inhalation usually. The vapor enters 
the blood through the lungs with extreme rapidity, 
reaching the tissues and producing its characteristic 
effects almost instantaneously. 

Amyl nitrite is a motor depressant. Its leading 
physiological action is upon the spinal cord and the 
circulation, other effects being secondary. The motor 
centres in the cord are directly and strongly depressed, 
and a similar but less powerful action is exerted on the 



THE CARBON COMPOUNDS. 141 

motor nerves and muscles. The sensory nerves are but 
little affected. 

Two effects are produced on the circulation. First, 
the muscular walls of the arteries are paralyzed; the 
vessels dilate, and the blood pressure falls. Second, 
by this reduction of the blood pressure the resistance 
which was met by the left ventricle in discharging its 
contents disappears, with consequent relief to the heart, 
which has at once less work to do, with the same, or in- 
creased, strength to do it. The heart-beats are increased 
in number — not always in force, — and the depression 
of the inhibitory apparatus gives the beats an energetic 
and thumping character. 

In this way amyl nitrite acts as a heart stimulant, 
not by actually strengthening the heart itself, but by 
clearing away obstructions to a free circulation which 
increased the work of the heart and exhausted it by 
compelling it to put forth abnormal exertions. 

From 2 to 5 drops, inhaled, will give this result, with 
the attendant symptoms of fulness and throbbing of the 
head, amounting sometimes to severe pain. 

If inhalation is carried beyond this there will be 
vertigo; flushing of the face, with visible pulsation 
of the carotids; deep, labored respiration; tingling of 
the surface; dilatation of the pupils; restlessness and 
anxiety. These symptoms disappear rapidly on the 
withdrawal of the drug, and the heart-beats fall to 
normal. 

It is stated that all objects look yellow to one fully 
under the influence of amyl nitrite. 

Larger doses increase all these symptoms in severity, 
to the point of grave depression, with cold extremities; 
heavy, clammy perspiration; slow, almost impercep- 
tible pulse; irregular respirations; and severe persistent 
headache. There may sometimes be convulsions. 
Toxic doses paralyze the heart and respiratory centres. 
In cases of poisoning by amyl nitrite all the blood of 
the body becomes a uniform hue, which is described 
as being nearer a chocolate color than ordinary venous 
blood. 



142 MATERIA MEDIC A FOR NURSES. 

The poisonous dose is not certainly known. A des- 
sert-spoonful taken internally has been recovered from, 
by the aid of emetics, and hypodermically 3 ii. have 
been given in an hour and a half without unpleasant 
symptoms. 

In giving inhalations of amyl nitrite, from 3 to 5 
drops are placed on a handkerchief, or piece of lint or 
cotton, held near the nose, and withdrawn as soon as 
fulness in the head or flushing of the face is produced. 
The symptoms usually are a little more prominent for 
a moment or two after the drug has been withdrawn. 
It has been given hypodermically and also by mouth. 
In the latter way the dose is TT[ ii.-iii. on sugar (tt^ x. 
= gtt. xxx.). (0.1-0.18 Cc.) 

Amyl nitrite escapes by the kidneys. The urine is 
increased in amount and in acidity, and may sometimes 
contain sugar. 

Nitro-Glycerinum (Nitro-Glycerin), Trinitrin, 
Glonoin. 

Made by dropping glycerin in a mixture of sulphuric 
and nitric acids kept ice-cold; separating by pouring 
the product into water, washing, and evaporating to a 
proper density. A colorless, oily liquid, odorless, with 
sweet, pungent taste; slightly soluble in water and 
freely so in oils, alcohol, and ether. 

If heated in a close vessel, or if subjected to per- 
cussion, it will explode. Mixed with porous silica, 
nitro-glycerin constitutes dynamite. It is never used 
undiluted in medicine. If spilled on the floor it may 
be dangerous. Pour potassium hydroxide on it to 
cause decomposition. 

Spiritus Glycerilis Nitratis. 
Spirit of Glyceryl Nitrate. 
Spirit of Nitro-Glycerin. 

A one-per-cent. alcoholic solution of glyceryl trini- 
trate. It should be kept cool, away from lights or fire. 



THE CARBON COMPOUNDS. 143 

Physiological Actions. 

Nitroglycerin is the most powerful of the nitrites. 
Its physiological actions resemble very strongly those 
of amyl nitrite but in a greater degree, and the effects, 
while less prompt in appearing, are more lasting, being 
developed in from three to five minutes, and continuing 
for about forty-five minutes. 

Depression of the motor centres, dilatation of the 
blood-vessels, and lowering of the blood pressure are 
the chief factors in the action of nitro-glycerin. The 
first signs manifest are perspiration and quickened 
heart action, with, sometimes, a dicrotic pulse; dis- 
turbed respiration, flushed face, vertigo, constriction 
of the head and throat, occasional nausea, throbbing of 
the carotids, and headache, which is of a severe frontal 
type, and lasts sometimes for hours after other effects 
have worn away. In some cases albumin in the urine 
is diminished by nitro-glycerin. 

Symptoms of Poisoning. 

Poisonous doses cause heart failure, with slow, inter- 
mittent, and very irregular pulse; dilated pupils; a 
feeling of weakness in the epigastrium; and intense 
headache, with a feeling as of a tight band around the 
head. 

Symptoms of poisoning not resulting in death have 
followed doses of from two to ten drops of the alcoholic 
solution. 

Nitro-glycerin is given in tablets, or in the form of 
the alcoholic solution, strength i per cent. This prep- 
aration should be constantly renewed, as it decom- 
poses with age. In the case of an unconscious patient 
it may be dropped on the back of the tongue. Dose, 
ni ss.-ii.; iii.; in a little glycerin (tt[ x. = gtt. xxv.). 
(0.03-0.18 Cc.) 

Phenol (Carbolic Acid). 

Phenol is a product of the distillation of coal tar. It 
may also be obtained by the distillation of other organic 



144 MATERIA MEDICA FOR NURSES. 

substances, and, finally, may be made artificially — 
synthetic carbolic acid. Crude phenol is an imperfectly 
purified article, the result of two distillations. It is a 
dark-reddish liquid, useful as a disinfectant, and cheap. 
Further distillations produce pure phenol, which is 
colorless, crystallizes in needles, and, if absolutely pure, 
does not absorb water from the air. 

If 5 to 10 <?o of water be added to the melted crystals, 
phenol will remain clear and not recrystallize on cool- 
ing; the further addition of water will cause a separa- 
tion, phenol going to the bottom as an oily layer, the 
mixture not becoming clear again until 90 to 95 $ of 
water has been added. The standard solution for 
ward use is made 1 part in 20 parts of water. The 
phenol and water should be well mixed, as they do not 
readily combine. Phenol is freely soluble in glycerin, 
alcohol, and ether. It sometimes acquires a reddish 
color on exposure, said to be due to minute quantities 
of metal, probably copper, contained in traces of the 
tar products present. 

Physiological Effects. 

Phenol applied locally is antiseptic, irritant, and 
anaesthetic. In concentrated form it is a severe 
caustic. The vapor, internally, is stimulant and dis- 
infectant. Taken into the stomach, the acid arrests 
fermentative changes, and in large doses is a powerful 
irritant and narcotic poison, acting on the respiratory 
and vasomotor centres, which it quickly paralyzes. It 
is rapidly absorbed by the unbroken skin, the sub- 
cutaneous tissues, the mucous surfaces, wounds, the 
respiratory passages, and the stomach, and is excreted 
by the urine, to which it gives a dark, smoky, or green- 
ish color; also by the saliva, which is increased in 
quantity. 

Phenol is a deodorizer and disinfectant as well as 
an . antiseptic. It is very destructive to low forms of 
life if used in sufficient strength, but in solutions of a 
strength which may be safely used externally, as in 
the dressing of wounds, or internally, as for vaginal 



THE CARBON COMPOUNDS. 145 

douches, it only prevents the development of germs, 
and does not kill their spores. Used constantly, as in 
dressings, even dilute phenol will produce in time a 
gangrenous condition. 

Symptoms of Poisoning. 

The first signs of poisoning from the use, either ex- 
ternal or internal, of phenol, are: giddiness, tension of 
the head, and, usually, the dark color of the urine. 
More serious evidences of danger are : contracted 
pupils; pallor; embarrassed breathing; a small, slow, 
feeble pulse; ringing or singing in the ears; and sud- 
den vertigo. 

When swallowed in poisonous doses there is at once 
a hot burning sensation from mouth to stomach, and 
the symptoms come on immediately. The lips and 
lining of the mouth are white and hardened; there is 
nausea, with violent pain and vomiting of frothy 
mucus; the lips, ears, and eyelids are livid; the pupils 
contracted and insensible to light. The skin is cold 
and covered with clammy perspiration; the pulse very 
feeble and almost always rapid, — 120 — though it has 
been known to fall to 40 or 50 a minute; the respirations 
are rapid, irregular, and difficult, sometimes stertorous, 
sometimes gasping, and the breath has the odor of the 
acid. Insensibility, coma, and collapse follow quickly 
in succession, and death may occur within a few 
minutes from paralysis of the respiration, or, if a very 
large amount has been taken, from paralysis of the 
heart. The average time of death is between one and 
ten hours, and the fatal dose may range from 3 i. to 
I ss. (4-16 Gm.) 

Treatment of Poisoning. 

In the treatment of this poison emetics are not al- 
ways of use, owing to a paralyzed condition of the 
stomach, and the stomach-pump should be used, wash- 
ing out the stomach with 50 <f alcohol. The chemical 
antidotes are sulphate of magnesia or of soda, or syrup 



146 MATERIA MEDICA FOR NURSES. 

of lime, and they should be freely given ( J iii. of the 
sulphates have been given) as long as the patient can 
swallow, or until there is improvement. Lime water 
and milk in equal parts may be given, and vegetable 
demulcents — as flaxseed tea, — but no oils or glycerin, as 
they dissolve the acid and aid its absorption. Atropine 
is a physiological antagonist, maintaining respiration; 
and cardiac stimulants may be required, given hypoder- 
mically. 

Phenol is in general use as an antiseptic and disin- 
fectant, though the manner of its employment has been 
greatly modified and changed in some respects from 
that of former years. For the practical w r ork of the 
nurse in cleaning and disinfecting it stands high, and 
is used in a strength cf 1 in 20 or 1 in 40. Articles to 
be disinfected, viz. soiled clothing, sputum cups, etc., 
must soak in it for varying lengths of time, according 
to the nature of the case. 

Phenol may be used for clothing, as it does not stain. 
In the sick-room its strong odor makes it unpleasant 
to many persons, and this odor may be covered by using 
oil of peppermint or cinnamon. 

Dose, rr[ i.-iii. (tt[ x. = gtt. xviii.) in glycerin or 
simple syrup — well diluted. 

There is a large and constantly increasing group of 
compounds allied to phenol, called cresols. They are 
derived from coal tar, and possess strong antiseptic and 
germicidal powers. As a rule, they are less poisonous 
than phenol. Among them may be mentioned creolin, 
lysol, saprol, sozal, chlorphenol, pheno-salyl, aseptol, 
etc. The well-known Dobell's solution contains phenol, 
sodium bicarbonate, borax, and glycerin. 

Creosotum (Creosote). 

Creosote is produced by the distillation of wood tar, 
and is a very complex substance, containing many 
hydro-carbons, some of which are closely related to 
phenol. Creosote is not as poisonous as phenol, nor so 
active as a germicide and antiseptic, but many of its 



THE CARBON COMPOUNDS. 1 47 

physiological properties are similar, and its value me- 
dicinally is about the same, though it is oftener used. 

It is a stimulant, expectorant, and gastric seda- 
tive. In the stomach it checks fermentation, yet does 
not interfere with digestion. The vapor is disinfec- 
tant and deodorant. When inhaled it is stimulant, 
and when ordered in this way it is convenient to use a 
small cone, which may be easily improvised. 

Only a few cases of poisoning are recorded. The 
symptoms and treatment are like those of phenol. 

Dose, M\ i.-iii. (tt[ x. = gtt. xx.). (0.06-0.2 Cc.) 

Aqua Creosoti. 
Creosote Water. 

Strength, 1 per cent. Dose, 3 i. — ii- (4-8 Cc.) 

Guaiacol. 

Obtained by distilling beechwood-tar creosote, and 
used in the treatment of pulmonary phthisis, etc. 
Derivatives of guaiacol: 

Guaiacolis Carbonatis = Duotal. 
Benzosal. Guaiacol Carbonate = Duotal. 
Styracol. " Salicylate = Guiacol-Salol. 

Acidum Salicylicum (Salicylic Acid). 

Salicylic acid is prepared synthetically by treating a 
solution of carbolic acid in caustic soda with carbonic 
acid, at a moderate heat. It is also found in nature in 
oil of wintergreen, in sweet birch, and in the bark of 
several varieties of willow. A dull white powder, 
readily soluble in alcohol and glycerin, but almost in- 
soluble in cold water. In hot water it is more readily 
dissolved, and borax and boric acid assist the solvent 
action. 

Physiological Actions. 

Salicylic acid is an antiseptic and disinfectant. It 
is a diaphoretic and antipyretic in fever, but does 



148 MATERIA ME BIC A FOR NURSES. 

not lower the temperature in health. It is not much 
used in this way, as other antipyretics are more lasting 
in influence and less depressing than salicylic acid. 

After an antipyretic dose there is slight temporary 
stimulation of the heart; the face and eyes are suffused 
and there is a feeling of warmth, followed by perspira- 
tion. These effects are visible in ten or fifteen minutes, 
and following them there is a reduction of the strength 
of the heart. 

Salicylic acid has a stimulant and disinfectant action 
on the kidneys and urinary apparatus, and increases 
the acidity of the urine. In some cases it irritates the 
kidneys and causes hematuria or albuminuria. 

In small doses it stimulates digestion, the heart, 
and respiration, but in large doses it depresses the last 
two, lowers arterial tension, and causes nausea and 
vomiting. 

bicidental Effects. 

In giving salicylic acid the first evidences of over- 
dosing which are to be looked for are buzzing and 
roaring in the ear, and fulness of the head. Increased 
doses bring severe headache, perspiration, deafness, 
and various disturbances of vision; and, if still con- 
tinued, these symptoms are all intensified. The respi- 
rations become deeper and are labored, rapid, and 
irregular — sometimes the most violent respiratory 
efforts being made to overcome the dyspnoea ; the 
pulse is slow and weak, and there is a great restless- 
ness, with a delirium characterized by hallucinations 
of vision, and which is sometimes cheerful, sometimes 
melancholy, and sometimes wildly maniacal. The 
urine may be dark olive-green, and involuntary evacu- 
ations of the bowels may take place. 

The depression of the circulatory system causes a 
relaxed state of the skin, and bed-sores are liable to 
appear rapidly. Eruptions of the skin, somewhat re- 
sembling that of urticaria, may appear even after 
medicinal doses. 

Salicylic acid is not considered an active poison to 



THE CARBON COMPOUNDS. 149 

man. Cases of death from its use have been recorded, 
but they are not all well verified, and poisonous symp- 
toms almost always disappear, on the withdrawal of the 
drug, in a few days, or a week. 

Salicylic acid is transformed in the blood into salicy- 
late of sodium, and is slowly excreted by the urine, 
perspiration, saliva, bile, and mucous secretions. 

Dose, gr. v.-xx. (0.3-1.2 Gm.), moderately diluted. 

Sodii Salicylas. 
Sodium Salicylate. 

Made by the action of salicylic acid on carbonate of 
sodium. It is readily soluble in water; has the same 
physiological actions as salicylic acid, and is less irrita- 
ting. It has no antiseptic qualities in external use. It 
is considered a specific in rheumatism, and in giving a 
course of it the same incidental symptoms mentioned 
under salicylic acid are to be looked for. 

Dose, gr. v.-xx. (0.3-1.2 Gm.), moderately diluted. 

Phenylis Salicylas. 
Phenyl Salicylate. 
Salol. 

A preparation composed of two thirds salicylic and 
one third carbolic acids. It is insoluble in water and 
is given in compressed tablets. 

Salol is antiseptic and antipyretic; sedative to 
the brain and spinal cord, and with some power as an 
analgesic. It is an active diaphoretic, and though 
in some cases it has a somewhat depressing effect, yet 
its action is usually not marked by as much exhaustion 
as that of many of the new antipyretics, and when the 
temperature rises after being reduced by salol, it does 
so without chill or chilly feelings. Its physiological 
effects and medicinal uses are in general very like those 
of salicylic acid. It is not considered poisonous, and 
is, like iodoform, used as a topical application. 

Dose, gr. v.-xv. (0.3-1. Gm.) 



I50 MATERIA MED1CA FOR NURSES. 

OUum Gaultherte. | See 0r S anic Materia Medica - 
Thiersch Powder. 

A combination of salicylic and boric acids, usually- 
ordered in the proportion of % ss. of the latter to 3 ss. 
of the former. Added to one quart of water it forms 
an antiseptic solution, of moderate power, which is not 
irritating or poisonous when freely used. The propor- 
tions of a Thiersch powder are not invariable, as Prof. 
Thiersch does not confine himself to one formula. 1 

Sodio-Theobromine Salicylate. 
Diuretin. 

Diuretin is made from theobromine, an alkaloid ob- 
tained from the seeds of theobroma cacao, the choco- 
late tree of South America, and sodium salicylate. It 
is a white powder, soluble in half its weight of warm 
water. As the theobromine separates from it on ex- 
posure to the air, it should not be given as powder, but 
as freshly prepared aqueous solution. 

Physiological Actions. 

It is a reliable diuretic, increasing the amount of 
urine, and the solids excreted by the urine. Its in- 
fluence over the amount of albumin is not constant. 
However, in chronic nephritis the amount of albumin 
is generally diminished. In dropsy, with the increase 
of urine, there is disappearance or marked improvement 
of the oedema. Occasionally a profuse diarrhoea is ap- 
parently produced by the remedy, and assists in this 
removal of the transudation. 

It is believed that the drug has a marked influence 
on the heart. It strengthens and regulates it, is not 
depressing, and produces no functional disturbance. 
It does not appear that it causes any irritation either 
of the stomach or kidneys. Its diuretic action depends 
on a direct influence on the renal epithelium. 

Dose for an adult, gr. xv.-xx. (1.-1.3 Gm.) 

1 Charles Rice, Ph.D. 



THE CARBON COMPOUNDS. 151 

Naphthalenum (Naphtalene). 

A coal-tar derivative with the taste and odor of tar; 
insoluble in water, soluble in ether, hot alcohol, and 
benzol. 

It is antiseptic and destructive to low forms of life. 
Internally it is a stimulant expectorant, and acts as 
a disinfectant to the alimentary canal. The latter 
action is a local one, as it is not readily absorbed into 
the system, but is mostly carried away by the faeces, 
that part of it taken up by the blood being excreted 
by the urine partly unchanged and partly as naphtol. 
Externally it is used as an antiseptic. 

Betanaphthol. 
Naphtol. 

Derived from naphtalene; soluble in alcohol, ether, 
chloroform, oil, and vaseline. It is more easily ab- 
sorbed than naphtalene, and causes vomiting, haema- 
turia, convulsions, and unconsciousness. In medicinal 
doses it is an intestinal disinfectant, in doses of 
gr. i.-iv. (0.065-0.25 Gin.). It is also used as a local 
application, dissolved in alcohol, in from 1 to 50$. 

Allied to naphtol are: 

Microcidin. Alumnol. 

Benzonaphtol. Hydronaphtol. 
Betol. Asaprol. 

Chinolin. 

Chinolin is a derivative of cinchona bark, from 
which it is named, and is also found in coal-tar oil. 
It is made synthetically by the action of glycerin on 
nitro-benzol and aniline. It is a colorless, oily liquid, 
and on exposure to the air turns dark. Like an alka- 
loid, it combines with acids to form salts. It is 
antiseptic. 

The taste and odor are very disagreeable. It re- 
sembles quinine somewhat in its antipyretic action. 



152 MATERIA MEDIC A FOR NURSES. 

After a full dose there is a short preliminary stage of 
excitement, with increased pulse and a feeling of 
warmth, followed by perspiration, fall of temperature, 
slow and weak pulse, and lessened respirations. In 
large doses it diminishes reflex action and causes 
dyspnoea, paralysis, and collapse. Only one salt, the 
tartrate, is used medicinally. 

Chinolin Tartras. 

Dose, gr. v.-xx. (0,3-1.3 Gm.), may be given with 
peppermint water. 

Chinolin is not in general use, and is here placed be- 
fore some of the more practically important antipyretics 
in an introductory way. Many of these medicines, 
which are synthetically prepared in laboratories, are 
the results of experiments made in the attempt to pro- 
duce an imitation of quinine, and several different ones 
are derived from chinolin. 

ANTIPYRETICS. 

These drugs are supposed to act upon the heat regu- 
lating centre of the body, throwing it out of function, 
the heat then accumulating in the body as it is formed 
by oxidation and other processes, until, by a diffuse 
dilatation of the blood-vessels, the body loses a large 
amount of heat, even chills and rigors with possibly 
sweating and collapse resulting. Large doses of these 
drugs "lake" the blood, break up the red blood cells, 
and form methsemoglobin. Cf. Potassium Chlorate, p. 
42. The cyanosis may be caused partly by this, partly 
by the dilated blood-vessels, and partly by the weak 
circulation due to collapse. The drugs so acting are 
antipyrine, acetauilide, resorcinol, and phenacetine. 

Antipyrina (Antipyrine). 

Antipyrine is a coal-tar derivative, being prepared 
from chinolin. It is an alkaloidal body, combining 
with acids to form salts. A whitish, crystalline powder 



THE CARBON COMPOUNDS. 1 53 

of slightly bitter taste, soluble in water in a proportion 
of ten parts to six parts of water. 

Physiological Actions, 

When first introduced it was a proprietary medicine 
and was known principally as an antipyretic. With 
further use and investigation other therapeutic qualities 
have been manifested. 

It is a general nerve sedative and anodyne, having 
a considerable degree of power in the relief of pain in 
various conditions of nervous origin. It is slightly 
antiseptic and disinfectant, diaphoretic, and has 
some diuretic action. It is also credited with being to 
some extent a haemostatic. Autipyrine does not lower 
the normal temperature, but in fever its action is very 
marked. There is a short period of stimulation, with 
flushing of the face, a feeling of heat, and increased 
action of the heart. In about half an hour or more 
perspiration breaks out and usually becomes very pro- 
fuse. " The pulse is then slowed, but not always weak- 
ened. The skin is cool; there may be chilly feelings, 
and the temperature falls from one to several degrees, 
according to the amount taken, and remains down for 
a length of time also proportioned to the dose — usually 
two or three hours, and often longer. 

There results very often — especially in subjects weak- 
ened by a long illness — a decided state of depression, 
sometimes so marked as to be alarming, and the pulse, 
though not always weakeued, is in some cases seriously 
so. The use of antipyrine in acute illness often causes 
nausea and vomiting, though it is not a gastric irritant 
in any special sense, but in small doses tonic, increas- 
ing the appetite. Symptoms which indicate danger in 
giving antipyrine are cyanosis, muscular weakness, dis- 
turbed and rapid respirations, weakened irregular pulse, 
dyspnoea, and sensations of heat over the body. Col- 
lapse may result from its use, and death in one instance 
followed the administration of fifty-odd grains. An 
eruption of the skin frequently occurs, with some con- 
stitutional disturbance and considerable suffering and 



154 MATERIA MEDIC A FOR NURSES. 

annoyance from the itching, which is severe. It lasts 
for several days, and in the majority of cases resembles 
the measles rash; but sometimes appears as a general 
and intense erythema, with swelling of the face, espe- 
cially about the eyes, burning sensations, and rise of 
temperature. Antipyrine has been given hypodermi- 
cally, but is irritant and liable to cause abscesses. If 
so given it should be injected deeply into the gluteal 
muscular tissue. 

Dose, gr. v.-xx. (0.3-1.3 Gm.), diluted moderately. 
It may be given in a little wine, or iced brandy and 
water; and to children, in syrup. 

Acetanilidum (Acetanilide). 
Antifebrine. 

A neutral substance derived from aniline by the 
action of glacial acetic acid. A colorless crystalline 
powder of slightly burning taste, soluble in alcohol, 
but not readily so in water. 

Its medicinal qualities are very similar to those of 
antipyrine, it being antipyretic, analgesic, and a 
nervous sedative. It has some differences of action. 
It diminishes the irritability of sensory nerves, lessens 
the reflex action of the spinal cord, raises arterial ten- 
sion to some extent, and slows the heart correspond- 
ingly. The reduction of temperature by acetanilide 
takes place rather more slowly than that caused by 
antipyrine — sometimes twice as much time being 
required. 

The effects last longer — six or seven hours — and the 
fall is sometimes, though not always, accompanied by 
perspiration rather less profuse than that produced by 
antipyrine. The lowering of the temperature is not 
supposed to depend on this diaphoresis, as experiments 
show that one sometimes follows without the other. 

The antipyretic action of acetanilide is occasionally 
followed by cyanosis, and in rare cases by collapse, 
though it is usually considered less apt than antipyrine 
to produce severe depression, and in the majority of 



THE CARBON COMPOUNDS, 1 55 

cases its use leaves no ill after-effects and does not 
nauseate. It has diuretic action and is a cerebral 
stimulant, while antipyrine depresses the brain. A 
poisonous dose destroys the ozonizing function of the 
blood. 

Incidental effects noticed sometimes after its use are 
deafness, ringing in the ears, dilatation of the pupils, 
and an eruption similar to that caused by antipyrine. 

Dose, gr. i.-xv. (0.06-1. Gm.) It may be given in 
dilute alcoholic solution, and, like many remedies to- 
day, is put up in compressed tablets. 

Allied to acetanilide are : 

Benzanilide. Exodyne. 
Antikamnia. Phenolide. 
Antinervine. 

Resorcinol. 

Resorcinol is obtained from galbanum, a resin, by 
the action of alkalies. It is also made from phenol, 
thus belonging to the phenol group of derivatives of 
coal tar. It occurs as white crystals with an odor re- 
sembling phenol, and is soluble in water, and also in 
alcohol. It is antiseptic and disinfectant, inferior, 
however, in these respects to phenol. It has consider- 
able antipyretic action, in large doses, causing free 
diaphoresis with reduction of the pulse and tempera- 
ture. The pulse may, within an hour, be slowed by as 
much as one third its former number of beats, and the 
temperature fall three or four degrees, to remain down 
for from two to four hours, when it rises again rapidly. 
While rising there may be chilly feelings, or a distinct 
chill. 

Doses which produce these results, viz., gr. xxx.-lx., 
cause also, as preliminary symptoms, dizziness, ringing 
in the ears, frontal headache, trembling, and quickened 
respirations. With the breaking out of perspiration 
these disturbances die away. No fatal case of poison- 
ing is known. In one case, where 120 grains were 
taken, giddiness and a feeling as of the pricking of 



156 MATERIA MEDIC A FOR NURSES. 

pins came on immediately. Unconsciousness followed, 
with subnormal temperature and thready pulse. 

The chief action of resorcinol is upon the nerve 
centres, and it has been shown experimentally that 
very large doses paralyze the heart. 

Dose, gr. ii.-v. (0.1-0.35 Gm.) 

It is used in an ointment, strength from 5 to 30 per 
cent. 

Pheno-Resorcin. 

A mixture of phenol and resorcinol, in the proportion 
of two thirds of the former and one third of the latter. 
Its qualities have not been thoroughly tested. 

Phenacetine. 

A preparation belonging to the phenol group; a de- 
cided antipyretic, being also antiseptic, sedative, 

and analgesic. After large doses profuse sweating is 
the first result, appearing in from thirty to fifty minutes, 
and in one or two hours the temperature begins to fall, 
reaching its lowest point in about four hours. The re- 
duction is quite marked, averaging about 3 , while a 
fall of 5 or 6° has been known. Some depression may 
follow — not severe enough usually to be alarming — 
with weak and chilly feelings and weakened pulse. 
The rise of temperature is more gradual than the fall. 
In comparison with the activity of other antipyretics, 
ten grains of phenacetine are said to equal fifteen grains 
of antipyrine or quinine, and thirty grains of salicylate 
of soda, and to be equal in power with antifebrine, 
though less rapid in action and more enduring in its 
effect. 

An eruption of the skin sometimes occurs in anaemic 
patients. 

Phenacetine is almost insoluble in water, and is 
given dry on the tongue, or in compressed tablets, or 
capsules. 

Dose, gr. iii.-x. (0.2-0.65 Gm.) 



THE CARBON COMPOUNDS. 1 57 

Allied to phenacetine are : 

Iodophenine. Hydracetine. 
Methacetine. Phenocoll Hydrochloride. 

Exalgine. 

A preparation introduced by French physicians, de- 
rived from acetanilide. It has analgesic power, and 
the name was given with reference to this quality, and 
does not describe its chemical constitution, as do many 
of the names of new remedies. It is hypnotic and 
anodyne, and comparatively free from ill after-effects. 

Its action in the relief of pain is rapid. In some 
cases, dizziness, trembling, weakness of the knees, and 
loss of muscular power in the eyelids have appeared 
almost immediately after its administration, passing off 
in a short time. 

It is given dry on the tongue, in powder or in tablets. 

Dose, gr. v.-x. (0.3-0.65 Gm.) 

Pyridine. 

Pyridine is found in nature as one of the principles 
of tobacco-juice, and is imitated in chemistry, and de- 
rived from chinolin. It is a volatile liquid with stroug 
aromatic odor. It gives off, at ordinary temperatures, 
a vapor which is used medicinally, having a stimulant 
effect on the respirations and on the spinal cord. On 
the heart it has an influence resembling that of digitalis, 
increasing the strength of the systole. 

Dose, iU v.-xx. (0.3-1.3 Gm.) 

Saccharin. 

Saccharin is a substance produced by a very compli- 
cated chemical process from a coal-tar product called 
toluene. It is the sweetest of known substances, being 
between two hundred and three hundred times sweeter 
than sugar, but in chemical constitution it is an acid. 



158 MATERIA MEDIC A FOR NURSES. 

It is not a food, like sugar, nor a medicine, as it has 
no special effect on the system. It may be used instead 
of sugar in diseases where sugar is forbidden. 

It has antiseptic power. 

Acidum Oleicum. 
Oleic Acid. 

A fluid fatty acid made from olein, the fluid principle 
of oils and fats, by the action of heated steam. It is 
used in the preparation of medicinal ointments called 
oleates, five of which are official, the oleate of vera- 
trine, strength 2 per cent., and the oleate of mercury, 
strength 20 per cent., oleate of cocaine 5 per cent., 
oleate of quinine 25 per cent., oleate of atropine 2 per 
cent. 

The oleate of zinc is also used. 

Petrolatum (Vaseline). 

Vaseline is a semi-solid substance obtained from 
petroleum by distillation and purification, and is used 
alone as an emollient, and also as the basis of various 
ointments. 

Glycerinum (Glycerin, Glycerol). 
Propenyl Alcohol. 

Glycerin is obtained by the reaction of fats and fixed 
oils with watery alkaline fluids. Chemically it is 
classed with the alcohols. It is always set free in the 
process of soap-making as a waste product, and so 
made is purified and sold, though the larger part of the 
glycerin in commerce is manufactured directly by the 
decomposition of fats by heated steam. 

Glycerin absorbs water from the air and mixes with 
water in all proportions. If pure it cannot become 
rancid. 

Applied externally it is unirritating to the sound 
skin, but painful if there be any abrasions. 



THE CARBON COMPOUNDS. 1 59 

It is slightly stimulant and antiseptic, and tends to 
make the skin dry and brittle. It is readily absorbed 
when applied externally. 

Internally it has no special effect on the stomach, but 
is supposed to have some nutritive power. It is pro- 
duced normally in the intestines during the digestion 
of oils and fats. If administered in free doses it has a 
laxative action, and for this purpose is given alone, or 
in combination with castor oil, in doses of \ ss.-i. 

The laxative action is very notable when glycerin is 
administered as an enema; a small amount — 3 ss.- § ii. 
— acts quickly and satisfactorily. 

Glycerin suppositories are also, in most instances, 
very efficacious. 



Preparations. 

Glyceritum Phenolis. 
Glycerite of Phenol. 

Contains 20 parts of phenol to 80 of glycerin. 

Glyceritum Acidi Tannici. 
Glycerite of Tannic Acid. 

The same strength as the above. 

Glyceritum Boroglycerini. 
Glycerite of Boroglycerin. 

Boric acid 3 parts to 7 of glycerin. 



PART IT. 

THE ORGANIC MATERIA MEDICA. 

THE VEGETABLE KINGDOM. 



Arranged under Botanical Divisions or Natural 
Orders. 



Nat. Ord. Ranunculacece : 

Aconitum (Aconite). 
Monk's-hood, Wolfsbane. 

Aconite is a tall perennial plant bearing a spike of 
blue flowers; found native in Europe, and cultivated 
in the United States. The official portion is the root, 
which is from 3 to 4 inches long, about f inch in 
diameter at the base, and tapers to a fine point. It is 
brown in color, externally, and has been mistaken for 
horse-radish, but the latter is whitish, does not taper 
gradually but has almost the same diameter for several 
inches, and has a strong odor when scraped, which 
aconite root has not. 

There are several varieties of the plant, all more or 
less poisonous. 

Physiological Actions. 

Aconite applied locally to the skin or mucous mem- 
brane acts on the terminations first of the sensory and 

161 



1 62 MATERIA MEDIC A FOR NURSES. 

next of the motor nerves, as a depressant or sedative, 
and causes tingling followed by numbness and insensi- 
bility. 

Taken internally aconite is sedative to the heart 
and respirations; is diuretic and diaphoretic, and 
reduces temperature. It has no effect on the brain. 
Medicinal doses, given close together, reduce the fre- 
quency, force, and tension of the pulse, produce a 
gentle perspiration, and increase the amount of urine. 
Respiration becomes slower and deeper; the tempera- 
ture falls. The tendency of the pulse under the in- 
fluence of aconite is to become small, compressible, and 
weak. 

L,arger doses, or a single full medicinal dose, produce 
a tingling feeling, usually first noticeable in the lips 
or extremities; or, if the impression be decided, the 
tingling may be felt over the whole body. 

There may be also a raw, irritable, or constricted 
feeling in the throat, and difficulty in swallowing, 
caused by anaemia of the throat. There is muscular 
weakness; giddiness and disorders of vision may be 
produced, especially if any exertion be made; the respi- 
rations are diminished, and the pulse may fall to 30 or 
40 a minute. 

The first effects of medicinal doses are usually shown 
in half an hour, and the symptoms mentioned will pass 
off in three or four hours. After poisonous doses, if 
large, death may occur immediately from instant par- 
alysis of the heart-muscles; or the symptoms may come 
on in a few moments and death occur soon after, the 
average time being between three and four hours. 

Symptoms of Poisoning. 

The first symptom of poisoning is the characteristic 
tingling, which is diagnostic of every variety and 
preparation of aconite. 

The pulse fails rapidly, becoming weak, irregular, 
intermittent, and slow; the respirations are shallow, 
weak, and sighing, irregular and slow. There is 



THE VEGETABLE KINGDOM. 1 63 

anaesthesia of the surface and great muscular weak- 
ness; the tongue and breath are cold; the skin covered 
with a cold sweat. The face has an anxious look and 
is sunken and livid. The eyes are glaring, the eye- 
balls protruding; the pupils are generally dilated. The 
voice is suppressed. There may be vomiting, although 
it does not always occur. The mind usually remains 
clear, but there are sometimes convulsions, and in these 
cases stupor and unconsciousness may be present. In 
the latter stages of collapse the special senses may be 
lost, especially the sight. 

Treatment of Poisoning. 

The first thing necessary is to empty the stomach 
and wash it out with the stomach-pump. Hot and 
concentrated alcoholic stimulants are given; external 
heat applied; the patient's head lowered beneath the 
line of his feet by taking out the pillows and elevating 
the foot of the bed; and absolute quiet and rest main- 
tained. Artificial respiration may be practised, and 
cardiac stimulants given hypodermically. 

Atropine is a physiological antagonist, stimulating 
respiration, and ammonia has the same effect. 

Digitalis counteracts the depression of the heart, but 
acts slowly, while aconite is exceedingly rapid in action. 

Precautions. 

The pulse should always be taken before giving a 
dose of aconite, and respirations and temperature 
watched. Any possibility of cold air or draughts must 
be guarded against, the skin being relaxed, and no ex- 
ertion on the part of the patient — such as sitting up in 
bed — allowed. 



Preparations of Aconite. 

1 Aconiti. 
Aconite. 

Dose, HI i.-ii. (tt[ x. = gtt. xxv.). (0.06-0.13 Cc.) 



Fluidextractum Aconiti. 
Fluidextract of Aconite. 



164 MATERIA MEDIC A FOR NURSES. 

Tinctura Aconiti. 
Tincture of Aconite. 

Made from the root. Strength 10 $, or § i.- 3 iii. in 
O. j. Dose, "fU i.-iv., in water. (0.06-0.25 Cc.) 

Fleming's Tincture of Aconite. 

Made from the root. Strength, 79 $, or § xss. in O. j. 
Dose, TTj, ss.-ii., in water. (0.03-0.13 Cc.) 

Aconitina. 
Aconitine. 

An alkaloid or active principle obtained from aconite. 
Dose, gr. ^-^. (0.0003-0.0013 Gm.) 

Linimentum Aconiti. 
Aconite Liniment. 

For external use; strength, 2 <f>. St. Jacob's oil, a 
quack medicine, contains aconite. 

Staphisagria (Stavesacre). 

The dried ripe seeds of Delphinium staphisagria. 
They possess four alkaloids, one of which, delphinine, 
is closely allied to aconitine, resembling it strongly in 
action. It is even more depressing. The only use of 
staphisagria is as a parasiticide. The preparation for 
this purpose is called delphine. 

Podophyllum (May Apple ; Mandrake). 

The dried rhizome 1 and rootlets of the May apple, a 
perennial herb of the Northern and Middle United 
States. An alkaloid, berberine, and two resins, are 
the active principles. 

Physiological Actions. 

Podophyllum is an active cathartic with chola- 
gogue properties. Its actions are shown not only 

1 Root stock. 



THE VEGETABLE KINGDOM, 1 65 

when taken internally, but also when applied to a 
broken surface or given hypodermically. It has a 
bitter, acrid taste, and causes slight salivation, irritation 
of the stomach, nausea, and griping pains. In large 
doses it causes severe colic. The purgative action is 
very slow, requiring ten hours or more, and is due to 
stimulation of the intestinal glands and of the muscular 
coats of the intestine; also to a stimulant action on the 
liver, with a decided increase in the flow of bile. 

In large quantities it may cause poisoning. Cases 
of poisoning in children have happened, with vomiting, 
purging, epileptiform convulsions, coma, and collapse. 

Preparations. 

Resina Podophylli. 
Podophyllum Resin. 

Dose, as a laxative, gr. ^. (0.005 G-m.) 
As a purgative, gr. \-\. (0.01. -0.015 Gm.) 

Fluidextractum Podophylli. 
Fluidextract of Podophyllum. 

Dose, TH v.-xv. (TTlx. = gtt. xii.). (0.3-1. Cc.) 
Podophyllum used externally is irritant, and may in- 
flame the eyes if carelessly handled. 

Cimicifuga (Black Snakeroot). 

The dried rhizome and rootlets of Cimicifuga race- 
mosa, an indigenous plant, containing a volatile oil, 
two resins, and tannin. 

Cimicifuga has antispasmodic action. In moderate 
doses it has been used as a stomachic and cardiac 
tonic, and it increases somewhat the action of the skin 
and kidneys. In large doses it slows the heart, and 
raises blood-pressure, acting like digitalis, and in ex- 
cessive doses it produces giddiness, severe headache, 
and prostration. No cases of poisoning are known. 
The preparations should not be kept long, as they spoil 
with age. 



1 66 MATERIA MEDIC A FOR NURSES. 

Preparations. 

Fluidextractum Cimicifugae. 
Fluidextract of Cimicifuga. 

Dose, Tq, v.-xx. {y\ x. = gtt. xii.). (0.075-0.3 Cc.) 

Tinctura Cimicifugae. 
Tincture of Cimicifuga. 

Dose, 3i.-ii. (4-8 Cc.) 

Adonis Vernalis. 

The root of Adonis vernalis contains a glucoside 
named adonidin. It is allied in action to digitoxin, 
one of the principles of digitalis, but is more powerful 
and irritating to the digestive organs. 

Physiological Actions. 

Adonidin stimulates the heart and vaso-motor 
centres, acting more promptly than digitalis. It is 
not cumulative in tendency. It has no special power 
as a diuretic, though there may be some slight action 
resulting from the effect upon circulation in the kidneys. 

In overdoses adonidin produces vomiting and diar- 
rhoea. 

Preparations. 

Adonidin. 

Dose, gr. ^. (0.02 Gm.) 
Infusion of Adonis Vernalis. 

Strength, 3 ss.-ii. of the root to § vi. 

Hydrastis (Golden Seal). 

The roots and root stocks of Hydrastis canadensis 
yield the alkaloids verberine, xanthopuccine, and hy- 
drastine, of which the last is the active principle. 



THE VEGETABLE KINGDOM, 1 67 

Physiological Actions. 

Hydrastis is an astringent bitter. It stimulates 
the gastrointestinal tract, creates appetite, and pro- 
motes the functions of the liver. It is also an anti- 
periodic. It is ecbolic, causing uterine contractions. 
Applied locally to mucous membranes it is tonic. 

In poisonous doses it has caused salivation, vomit- 
ing, muscular tremblings, loss of voluntary movement, 
rise of temperature, feeble, rapid pulse, convulsions, 
and death from failure of the respirations. 

Preparations. 

Tinctura Hydrastis. 
Tincture of Hydrastis. 

Dose, 3 i. (4 Cc.) 

Fluidextractum Hydrastis. 
Fluid Extract of Hydrastis. 

Dose, 3 ss. (2 Cc.) 

Hydrastininae Hydrochloridum. 
Hydrastinine Hydrochloride. 

A synthetic alkaloid obtained by oxidizing hydras- 
tine. It is an oxytocic and muscular stimulant. In 
overdoses a depressant to the whole motor tract. 

Dose, gr. \-\. (0.03-0.06 Gm.) 

Nat. Ord. Me7iisperntace<z. 
Calumba. 

The root of Jateorhiza palmata, of Eastern Africa, 
contains an alkaloid, berberine; a bitter neutral prin- 
ciple, colombin; and colombic acid. It contains no 
tannin, and may be given with iron. 

Calumba is a bitter tonic and stomachic, stimulat- 
ing the flow of saliva, the glands and blood-vessels of 



1 68 MATERIA MEDIC A FOR NURSES. 

the stomach, and also the gastric nerves, causing a 
sensation of hunger. Calumba, like bitters in general, 
has some power to overcome fermentation or decompo- 
sition in the stomach and intestines; promotes peristal- 
sis (bitters containing tannin have not this property); 
removes flatulence and tends to regulate the evacuation 
of the bowels. 

Bitters if given in excess or for a long time irritate 
the stomach and bring on indigestion. Calumba is 
one of the least irritating of this class of medicines. 

L,ike all bitter stomachics it must be given well 
diluted, and about half an hour before meals. 

Tinctura Calumbae. 
Tincture of Calumba. 

Strength, 20 $. Dose, 3 i-— ii. (4-8 Cc.) 

Fluidextractum Calumbae. 
Fluidextract of Calumba. 

Dose, fit xv.-3 ss. (fitx. = gtt. xiv.). (1-2 Cc.) 

Picrotoxinum (Picrotoxin). 

The fruit (called fish berries) of Anamirta paniculata, 
an Asiatic plant, yields an active principle, picrotoxin, 
a bitter neutral substance. 

It is an active excitant of the brain and spinal cord; 
stimulates secretions, especially of the intestines; causes 
nausea and vomiting, and slows the heart and respira- 
tions. In overdoses it produces muscular twitchings, 
stupor, delirium, convulsions, and coma; and may 
cause death by paralysis of the heart. 

The temperature is slightly raised by picrotoxin. 

It has been used externally in an ointment, and con- 
vulsions and death have followed its use in this way. 

Preparations. 

Picrotoxin. 
Dose, gr. -fari$> in pill. (0.0016-0.003 Gm.) 



THE VEGETABLE KINGDOM. 1 69 

Nat. Ord. Papaveracece. 
Opium. 

Opium is the juice of the unripe capsules of the 
Papaver somniferum or white poppy, thickened by- 
evaporation (inspissated), and is obtained by incising 
the capsules with a small sharp knife, when the juice 
flows forth, and hardens into a semi-solid mass. It is 
produced chiefly in Turkey, Asia Minor, Persia, and 
India. 

That used in the United States is almost all brought 
from Asia Minor and called Smyrna or Turkey opium. 
Granulated opium should contain from 12 to 12.5 % of 
morphine. 

When dried and powdered, opium is yellow brown in 
color, and dissolves in water, alcohol, and dilute acids. 

Opium is an exceedingly complex substance, con- 
taining the alkaloids morphine, codeine, narceine, 
narcotine, thebaine, papaverine, porphyroxine, crypto- 
pine, meconine, opianine, and paramorphine; meconic, 
thebolactic, and sulphuric acids; fixed oils, odorous 
principles, extractives, gum, resin, salts, glucose, and 
other unimportant substances, with about 16 per cent, 
of water. 

Physiological Actions. 

Opium is generally considered to be anodyne and 
anaesthetic when applied to the unbroken skin, yet 
some authorities consider this doubtful, and attribute 
any good effect from such application to the moist heat 
or to the resins and spirits of the liquid preparations. 
Mucous surfaces, wounds, ulcers, etc., readily absorb 
opium. The local action of the drug is astringent. 
In the mouth the mucous lining is dried, the tongue 
coated, and a sensation of thirst produced. In the 
stomach opium may cause a short period of irritation 
of the nerves, with nausea, but soon sensibility is 
diminished, the secretions checked, sensations of appe- 
tite and hunger are lost, the digestive powers fail, and 



I70 MATERIA ME DIC A FOR NURSES. 

the afferent nerves are depressed, so that the act of 
vomiting is produced with difficulty, and direct emetics 
may fail altogether. 

In the intestines opium is sedative and astringent. 
All impressions given to the nerves from the mucous 
membrane are weakened; the secretions are diminished, 
peristaltic action is checked, and pain relieved. 

Given by the rectum, as in enemata or suppositories, 
opium allays local pain, checks diarrhoea, and acts as 
an antispasmodic, keeping the parts at rest, and pre- 
venting irritability of the mucous membrane. 

The secretion of bile is diminished and the urine 
lessened in quantity. The bowels are constipated. 
The skin is the only organ whose action is not de- 
creased by opium. Perspiration, instead of being 
lessened, is excited, especially by some preparations, 
which are decidedly diaphoretic. 

Opium is eliminated by the breath, perspiration, 
urine, and milk. This last is to be remembered in 
giving opium to a nursing mother. 

The pre-eminent influence of opium is upon the brain 
as a stimulant, hypnotic, and narcotic. These actions 
are more prominent in man than in animals, and in 
highly civilized than in lower races. 

The stimulant effect is noticeable sometimes after a 
medicinal dose, and precedes the hypnotic action by a 
short variable period. In persons who are accustomed 
to large doses of opium the period of stimulation is 
more marked. The nerve centres which preside 
over the imagination are specially affected. The im- 
aginative powers are heightened and the will power 
weakened. 

Opium also acts upon the heart as a stimulant, sus- 
taining and strengthening it. The opium pulse re- 
sembles the healthy pulse, being strong, moderately 
slow, and regular ; full, compressible, and of moderate 
length, and is not disturbed by change of position, 
exercise, or mental agitation — an important difference 
between the action of opium and other cardiac stimu- 
lants. 



THE VEGETABLE KINGDOM. 371 

The anodyne effects of opium depend chiefly on 
morphine, its most important alkaloid. There are 
some differences of action between opium and morphine 
alone, as follows: opium is less soluble than morphine, 
is more slowly absorbed, and the effects last longer; 
its local action on the intestines is more pronounced; 
it reaches the bowels directly and is more constipating. 
For this reason it is preferred in many cases of intestinal 
trouble. 

Opium is not as powerful a narcotic as morphine, as 
several of its other alkaloids (thebaine, codeine, and 
narcotine) have a more or less exciting or convulsant 
action which modifies the whole drug. 

Opium disorders the digestion more than morphine 
and has greater power as a diaphoretic. 

Finally, opium, being of variable strength, is not as 
reliable as morphine, the quantity of which in a given 
dose may be accurately determined. The relative 
strength of opium to morphine is about as -£■ or \ to 1. 

Symptoms of Poisoning. 

The mildest manifestation of opium on the brain is a 
quiet, dreamy state, ending after a short time in sleep, 
either light and natural or heavy, and passing into 
stupor, according to the size of the dose. There is 
hyperemia of the brain in the sleep caused by opium. 
On awakening there may be slight depression with 
headache and languor, caused by imperfect aeration of 
blood — which is in turn the result of diminished respi- 
rations — and lasting several hours. There may be 
nausea, or even vomiting, or the patient may return at 
once to the normal condition. This is the first stage 
of opium narcosis. After large doses the second stage 
comes on quickly, or at once. The symptoms of this 
condition are very like those of congestion of the brain. 

The pupils are contracted, the face flushed, often 
cyanosed; the pulse is full, slow, and strong; the res- 
pirations slow and deep, sometimes stertorous; the 
skin is usually dry and warm, and unconsciousness is 
apparently complete, though the patient can usually 



172 MATERIA MEDIC A FOR NURSES. 

be roused, and if so, the breathing becomes more rapid 
and the face regains its natural color. 

There is usually retention of urine. Death does not 
often occur in this stage of opium narcosis. 

The third stage is that of prostration with profound 
coma, from which it may be impossible to rouse the 
patient; but, if he can be roused and made to speak, 
his answer, though it may not be complete, will be 
rational, and there will be no thickness or indistinct- 
ness of articulation, as there is in alcoholic poisoning. 
This is characteristic of opium poisoning. The respira- 
tions are weak, shallow, irregular, and slow; they may 
fall to one or two in a minute, while in the second stage 
they may frequently be found as low as four or five. 
The face is pallid and cyanosed; the skin cold and 
covered with perspiration; the pupils are absolutely 
contracted, and just before death they dilate widely. 
The pulse becomes more and more rapid and weak, and 
death results from failure of the respirations. 

Treatment of Poisoning. 

In treating opium poisoning the stomach-pump 
should be employed every half-hour until the patient 
is out of danger. Removing contents of stomach once 
is not sufficient, because any opium that may have 
been absorbed is secreted into the stomach and must 
be removed to prevent reabsorption. 

Potassium permanganate (3-5 gr. in a glass of water) 
should be the first thing given, and it should be given 
every half- hour, just after the stomach is washed out 
with the stomach-pump. Atropine, strychnine, and 
caffeine may be used hypodermically as stimulants and 
to counteract the systemic effect of the opium. Care 
must be taken that the patient does not become chilled 
or exhausted. Too vigorous exercise or physical 
stimulation is not good. 

The treatment of opium poisoning is mainly directed 
toward maintaining respiration, and in those cases 
where symptoms of narcotism arise gradually after the 
giving of medicinal doses, it is enough simply to work 



THE VEGETABLE KINGDOM. 1 73 

toward this one object, by rousing the patient and try- 
ing to keep him roused until the effects wear away of 
themselves. Naturally, in the case of narcotism after 
hypodermic injections, emetics would be useless. 
Black coffee, as strong as possible, is given through a 
tube into the stomach, if necessary, or by rectum, as it 
will sometimes be difficult to make the patient swallow. 

In those cases where a large dose has been taken by 
mouth, the stomach must be emptied. A tablespoon- 
ful of mustard in a glass of warm water may be given, 
and repeated in ten minutes, and gr. xxx. each of 
ipecac and sulphate of zinc may be afterwards given 
and repeated once or twice at intervals of fifteen min- 
utes, with plenty of warm water. If emetics refuse to 
act on the torpid stomach, the stomach-pump must be 
used, but, though it acts better than emetics when fluid 
preparations have been taken, it is useless if the solid 
drug has been used. 

After washing out the stomach, respiration must be 
supported in every possible way, yet measures which 
may exhaust the patient's strength are to be avoided. 
Black coffee is given as before mentioned. Cold or 
alternate hot and cold douches may be applied to the 
head and chest. Artificial respiration should be kept 
up untiringly, for hours if necessary, or the battery 
may be used. 

The bladder must be emptied by the catheter, to pre- 
vent reabsorption, and the temperature kept up by the 
application of external heat. 

Various cardiac and respiratory stimulants are given 
hypodermically; atropine is a physiological antagonist 
to the action of opium on respiration, being the most 
active known respiratory stimulant; but it is necessary 
to regulate the amount given with great precision and 
with a thorough understanding of the entire physio- 
logical relation of one to the other. Lacking this, it 
would probably be given rashly, and atropine poison- 
ing be added to the opium narcosis. For this reason 
the administration of atropine should not be under- 
taken except under directions from a physician. 



174 MATERIA ME DIC A FOR NURSES. 

There are usually no sequels to opium poisoning. 
The amount which may cause death varies greatly with 
idiosyncrasy or the habits of the patient. Recovery 
has taken place after 55 grains of solid opium and 
again after 6 ounces of laudanum had been taken, 
while 4 grains of crude opium have caused death. 

Incidental Effects of Opium. 

Idiosyncrasies are very common in regard to opium, 
especially among delicate nervous women. Severe de- 
pression sometimes follows ordinary doses, marked 
especially by excessive vomiting. In these cases, 
nausea is not felt while the patient is lying down, but 
recommences on rising. Delirium sometimes follows, 
or retention of urine. A common result, noticed when 
the effects of a dose are wearing off, is an itching, 
sometimes general, sometimes confined to the face and 
especially the nose; and erythema — red stains or 
blotches — appears on the face. Children and old people 
bear opium badly. With children this is accounted 
for by the disproportionately large size of brain; and 
women are more susceptible to its action than men. 

In conditions where there is severe suffering, much 
larger doses than ordinary can be safely taken, for the 
power of the drug then seems to be spent in overcoming 
the pain. 

Preparations of Opium, 

Solid Preparations. 

Extractum Opii. 
Extract of Opium. 

Double strength. Dose, gr. J-i. (0.015-0.06 Gm.) 

Pilulae Opii. 
Pills of Opium. 

Strength, about one grain to one pill. 
It is to be remembered that opium pills, if old, are 
dry and hard to dissolve, and if given in succession 



THE VEGETABLE KINGDOM. 1 75 

may produce alarming symptoms by accumulating in 
the alimentary canal and dissolving all at once. 

Liquid Preparations. 

Tinctura Opii Camphorata. 
Camphorated Tincture of Opium. 
Paregoric. 

Contains gr. ii. of opium to § i. ; also benzoic acid, 
oil of anise, and camphor. Owing to the camphor it is 
more constipating than the other preparations. 

Dose for an adult, |ss.-§i.; for a baby under one 
year, TT[ i.-v.; for a child under two years, TT[ v.-xv.; 
under three years, tt[ v.-xx. ; under four and five years, 
TTt v.-xxv. ; under ten years, TT[ xx.-xxx.; under 
fifteen years, TT[ xxx.- 3 i.-ii. 1 

1 rrt i. = o 06 Gm. iU v. = 0.3 Gm. v\ x. = 0.65 Gm. v\ xv. 
= 1. Gm. tii, xx. = 1.3 Gm. ttx xxv. = 1.5 Gm. 

(tt[ x. of paregoric equal gtt. xx. and gr. -f^ of 
opium.) 

Tinctura Opii Deodorati. 
Deodorized Tincture of Opium. 
McMunn's Elixir. 

Contains no narcotine and none of the odorous prin- 
ciples, and is therefore less nauseating than laudanum. 
Dose, TTj, viii.-xv. (0.5-1. Cc.) (TTt x. = gtt. xvii. One 
grain is represented by twelve minims). The strength 
is 10 <f . 

Tinctura Opii. 
Tincture of Opium. 
Laudanum. 

Dose, tt[ viii.-xv. (0.5-1. Cc.) (tt[ x. = gtt. xx.) 
Strength, 10 <f> 



176 MATERIA ME DIC A FOR NURSES. 

Other Preparations Containing Opium. 

Pulvis Ipecacuanhae et Opii. 
Ipecac and Opium Powder. 
Dover's Powder. 

One powder of ten grains contains gr. i. of opium, 
gr. i. of ipecac, and gr. viii. of sugar of milk. An ex- 
cellent diaphoretic, though somewhat nauseating. 

To be taken at night. Dose, gr. v.-x. (0.3-.65 Gm.) 

Tinctura Ipecacuanhae et Opii. 
Tincture of Ipecac and Opium. 

Dover's powder in a liquid form. Strength, 10 # 
opium. 

Dose, the same as tincture of opium. 

Tinctura Opii Composita. 
Compound Tincture of Opium. 
Squibb's Diarrhoea Mixture. 

Contains tincture of opium, tincture of capsicum, 
spirits of camphor, chloroform, and alcohol. 
Dose, 3 i. (4 Cc.) 

Alkaloids of Opium. 

Morphina (Morphine). 

The official salts of morphine in dry form are as 
follows: 

Morphinae Acetas. 
Morphine Acetate. 

A white bitter powder, soluble in 2.25 parts of water; 
made from the hydrochloride of morphine by the action 
of acetic acid. 

Morphinae Hydrochloridum. 
Morphine Hydrochloride. 

Made by the action of hydrochloric acid; soluble in 
17.2 parts of water. 



THE VEGETABLE KINGDOM. l^J 

Morphinae Sulphas. 
Morphine Sulphate. 

Made by the action of sulphuric acid. Soluble in 
15.3 parts of water. 

The dose of all these salts in solution is gr. \-\. 
(0.015-0.008 Gm.) 

The present Pharmacopoeia gives no standard solu- 
tion of any morphine salt. The old familiar solution 
of the strength of one grain to the ounce, called among 
nurses and doctors " U. S.," is no longer official. 

Pulvis Morphinae Compositus. 
Compound Morphine Powder. 
Tully's Powder. 

Ten grains contain gr. \ of morphine, with camphor, 
glycyrrhiza, and calcium carbonate. 

Tinctura Chloroformi et Morphinae. 
Tincture of Chloroform and Morphine. 

Contains a small amount of morphine, with ether, 
alcohol, oil of peppermint, liquorice, and syrup. 
Dose, v\ x. (0.65 Gm.) 

Magendie's Solution of Morphine. 

This preparation is not official; it contains gr. xvi. 
of morphine to 3 i., and it is used almost entirely hj^po- 
dermically. If it is old, or exposed to the air, it de- 
velops a fungus which unfits it for use. It is not 
irritating to the tissues. 

The analgesic and narcotic action of morphine is 
quickly manifested, coming on usually within half an 
hour after an ordinary dose, sometimes in a few mo- 
ments. The length of time during which these effects 
last varies much with the condition of the patient, the 
degree of pain present, and the extent of toleration of 
the drug which has been established. The average 
may be put at four or five hours. (tt|, x. = gtt. x.) 



1^8 MATERIA MEDIC A FOR NURSES. 

Codeina (Codeine). 

Codeine has slightly exciting action on the spinal 
cord. Its hypnotic action is feeble and uncertain. It 
is not constipating. 

Dose, gr. \-\. (0.03 Gm.), usually in pill. 

The other alkaloids of opium resemble morphine 
somewhat, but are not used in medicine. 

Narcotine is wrongly named, as it has no narcotic 
power, and on animals acts as a tetanizer. 

Thebaine is a convulsant, almost like strychnine. 

Heroin. 

An acetic ester of morphine in the form of a white, 
crystalline inodorous powder of a faint, bitter taste. 
It is used as a sedative and increases the amount of air 
taken into the lungs, while decreasing the rate of 
respiration. It is a favorite remedy for children. Dose 
for adults, gr. ^q~tV (0.003-0.006 Gm.) in powder or in 
aqueous solution, with the addition of a few drops of 
acetic acid. It has feeble analgesic and hypnotic 
properties. Habit is frequently established, as with 
morphine. 

Apomorphinae Hydrochloridum. 
Hydrochloride of Apomorphine. 

Prepared from morphine by the action of hydrochloric 
acid. An active and certain emetic, which acts indi- 
rectly or through the vomiting centre in the medulla. 
It may therefore be given hypodermically if the patient 
be unable to swallow. In from five to twenty minutes 
it causes nausea and repeated vomiting. 

If taken by the stomach it does not irritate, and 
leaves no ill after-effects. Very large doses cause pros- 
tration and paralysis of the voluntary muscles and de- 
pression of the respiratory centre. 



THE VEGETABLE KINGDOM. 1 79 

Small doses are expectorant, but it is not much 
used in this way. 

Expectorant dose, gr. iV-yV (0.006-0.004 Gm.) 

Emetic dose, gr. \. (0.012 Gm.) 

Emetic dose, hypodermically, gr. T V every 10 min- 
utes. 

Emetic dose, hypodermically, for an infant, gr. 
-sV-tV > an( * f° r a cn ^ld °f IO years, gr. -gV- (0.002- 
0.003-0.004 Gm.) 

.M?/. Ord. Crucifercz. 

Sinapis (Mustard). 

The mixed and powdered dried ripe seeds of Brassica 
alba and Brassica nigra, grown in temperate regions. 

Black mustard seeds contain various principles, the 
most important one being a volatile oil, oleum sinapis, 
which is set free when water is added. 

It is a pale-yellow or colorless fluid, of intensely 
pungent and penetrating odor, burning taste, and a 
blistering and corrosive action on the skin. 

White mustard seeds do not possess this volatile oil, 
but contain a rubefacient principle which resembles it, 
and which is set free in the same way on the addition 
of water. 

Physiological Actions. 

Applied externally, as in poultices, baths, etc., mus- 
tard is a nerve stimulant, rubefacient, and vesicant, 
causing redness, heat, and severe burning pain, and, 
if long applied, blistering. Relief of previous pain and 
loss of sensibility to other impressions follow the action 
of mustard. The heart, blood-pressure, respirations, 
and nerve centres generally are first stimulated, then 
quieted, and, if vesication has resulted, depressed, even 
seriously. In baths, mustard dilates the vessels of 
the skin and relieves the blood-pressure in congested 
organs. 



180 MATERIA MEDIC A FOR NURSES. 

The principles of counter-irritation are, first: that, 
by causing dilatation of the vessels of that part to 
which application is made, there is contraction of the 
vessels in other parts of the body, especially if there is 
nervous connection between the two, and following this 
principle, counter-irritants are usually applied at some 
distance from the congested part, as in the use of foot- 
baths; second, that, by increasing the activity of the 
circulation, counter-irritants promote the reabsorption 
of inflammatory products, and for this purpose they are 
sometimes applied directly over the affected region. 

In making mustard paste, the addition of the white 
of an egg modifies the local irritant action, making it 
more easily borne by the skin, and less liable to injure 
its structure, while it does not interfere with the phy- 
siological effect. The paste should be mixed only with 
tepid water, as hot water dissipates the volatile oil, 
vinegar destroys it, and alcohol prevents its formation. 
Internally, mustard in small amount, as taken with 
food, stimulates the appetite and gastric circulation. 
In large doses it is a rapidly acting stimulant emetic, 
leaving little or no depression. 

The action of mustard externally must always be 
specially watched with comatose patients, as injury to 
the skin does not show at first in a state of sluggish 
circulation, and may become serious before it is noticed. 
Kmetic dose, 3 ss., in warm water. 

Nat. Ord. Polygalacece. 

Senega (Snake-Root), 

The dried root of Poly gala senega, of the Middle and 
Southern United States. The active principle is sa- 
ponin, a glucoside, allied to digitonin, one of the active 
principles of digitalis. 

Senega acts upon the bronchial mucous membrane 
as a stimulant expectorant and also stimulates the 
skin and kidneys, increasing the amount of urine and 
its solid constituents. It is not readily absorbed by the 



THE VEGETABLE KINGDOM. l8l 

stomach. Small doses impair digestion, and large ones 
irritate the stomach and intestines, causing nausea, 
vomiting, and diarrhoea. 

Preparations of Senega. 

Extractum Senegas. 
Extract of Senega. 

Dose, gr. v.-x. (0.3-0.65 Gm.) 

Fluidextractum Senegae. 
Fluidextract of Senega. 

Dose, Til x.-xv. (0.65-0.975 Cc.) 

Syrupus Senegas. 
Syrup of Senega. 

Dose, 31. (4 Cc.) 

Nat. Ord. Sapindacecs. 

Guarana (Brazilian Cocoa). 

The seeds of Paullinia sorbilis. They contain an 
active principle, guaranine, which is similar to caffeine. 

Fluidextractum Guaranae. 
Fluidextract of Guarana. 

Dose, 3 i.-ii. (4-8 Cc.) 

Nat. Ord. Erythroxylacece* 
Coca. 

The coca tree Erythroxylon coca is cultivated in 
South America. The dried leaves have a bitter, aro- 
matic taste, and an odor like tea. They are extensively 
used by the natives, who chew them as a stimulant 
during hard labor, scarcity of food, etc. They contain 
an alkaloid, cocaine, the active principle. 

Coca in small doses is stimulant, tonic, and re- 
storative. It strengthens the heart and respirations, 



1 82 MATERIA MEDICA FOR NURSES. 

raises arterial tension, increases the supply of blood to 
the brain, producing wakefulness, and lessens the sen- 
sations of hunger and fatigue. It has diuretic action, 
and decreases the amount of urea by checking tissue 
waste. Under the influence of coca, or cocaine, the 
skin is flushed, the circulation excited, and a sense of 
heat and perspiration result. 

Cocaine in solution has decided action as a local 
anaesthetic. If applied to a mucous surface, as the 
tongue or conjunctiva, or if given hypodermically, it 
quickly paralyzes the sensory nerves and contracts the 
small vessels, producing a state of local anaemia and 
anaesthesia, which lasts for fifteen minutes, or longer, 
in proportion to the strength of the application. It is 
often used in this way for minor surgical operations 
(amputation of a finger; opening of an abscess, etc.). 
Applied to the eye it causes dilatation of the pupil, 
which begins in a few minutes, reaches its height in 
about an hour, and returns to the normal state in 
twenty-four hours. 

Symptoms of Poisoning . 

Overdoses weaken the heart and the pulse becomes 
small, rapid, and intermittent. There is a feeling of 
tightness about the chest; the respirations are slow and 
shallow, and the skin cold and clammy. There are 
sometimes hallucinations and delirium. Poisonous 
doses paralyze the sensory nerves and the respiratory 
centre. This has been shown by experiments on ani- 
mals, no fatal cases in man being known. 

Five grains taken by mouth have caused alarming 
symptoms: loss of sight, nausea, incoherent speech, 
cyanosis, rapid intermittent pulse, and a feeling of 
suffocation. In treating severe depression from the 
use of cocaine, alcohol, opium, and nitrite of amyl are 
used as antagonists. 

The habit of constantly taking large doses of cocaine 
is readily formed, and produces emaciation, insomnia, 
and disordered digestion. If carried to excess the in- 



THE VEGETABLE KINGDOM. 1 83 

tellect is weakened, even to insanity. The victim has 
an uncertain gait, an apathetic air, eyes sunken and 
surrounded with a deep purple ring, trembling lips, 
teeth crusted w T ith a greenish deposit, a peculiar black- 
ness around the corners of the mouth, and excessive 
fetor of the breath. Ascites sometimes appears, and 
death may result from a general wasting of the vital 
powers. 

Preparations of Coca. 

Fluidextractum Cocae. 
Fluidextract of Coca. 

Dose, 3 ss.-ii., moderately diluted. (2-8 Cc.) 

Cocainae Hydrochloridum. 
Cocaine Hydrochloride. 

The solution of the hydrochloride of cocaine is the 
familiar one, and is put up in varying strength, 2 per 
cent., 4 per cent., and 8 per cent., approximately. The 
2-per-cent. solution has gr. x. to |i.; therefore 3 i. 
equals gr. \\. The 4-per-cent. solution, the most com- 
mon one, contains gr. 2j in 3 i., gr. i} in TT[ xxx., 
gr. f in Tit xv. One grain is represented by TT[ xxiv., 
and the minims and drops are equal. Cocaine is used 
hypodermically as a heart stimulant. 

Dose, gr. -g-i. (0.008-0.06 Gm.) 

Nat. Ord. Linacea. 

Linum (Linseed; Flaxseed). 

The dried ripe seeds of the flax. They contain a 
fixed oil and a quantity of mucilage. The whole seeds 
are used to make a demulcent drink, flaxseed tea; 
ground into meal, they are used for poultices; and the 
oil, mixed with equal parts of lime-water, is called 
Carron oil, and is used as a dressing for burns. 

Flaxseed Tea. 

Pour one quart of boiling water over four ounces of 



1 84 MATERIA MEDIC A FOR NURSES. 

flaxseed (whole). Let it boil for half an hour, and 
afterwards stand near the fire for fifteen or twenty- 
minutes. Strain and sweeten it, and flavor with lemon- 
juice. 



Flaxseed Poultice. 

A flaxseed poultice must be made over a fire, or alco- 
hol lamp. The water must be boiling actively when 
the meal is added, and must continue to boil until the 
poultice is done. Flaxseed bubbles and seethes at a 
point of heat below the boiling point of water, and is 
thus deceptive if it is added to the water in the first 
place. It must be sprinkled in with the left hand and 
stirred constantly with the right. If added in handfuls 
the poultice will be lumpy. When it has reached a 
proper consistency, not thick enough to be stiff, nor 
thin enough to run, it must be taken off the fire and 
thoroughly beaten for several minutes. This makes it 
light and spongy. A perfect poultice will leave the 
spoon and vessel clean, and reaches this point by being 
sufficiently boiled. 

Flaxseed poultices are sedative. They relieve pain 
and relax spasm. In the early stages of an inflamma- 
tion they draw the blood to the surface and relieve 
congestion. Resolution may thus be brought about 
and the formation of pus avoided. 

If suppuration has begun, the action of poultices 
favors the process. It is, therefore, not considered 
well to use them in the later stages of an acute inflam- 
mation, as is often seen done in the home treatment of 
abscesses, etc. Such cases should be brought to a 
physician for proper treatment, and this is the more 
important if the inflammation is near a joint. 

Poultices, if kept up too long, give the tissues a 
flabby, water-soaked appearance; make granulations 
pale, flabby, and unhealthy; depress the circulation 
and the vaso-motor system, and may impair seriously 
the vitality of the part. 



THE VEGETABLE KINGDOM. 1 85 

Nat. Ord. Malvacece. 

Gossypium Purificatum (Cotton- Wool ; Purified 
Cotton). 

Cotton- wool is too familiar to need description, and 
is introduced here as the first step in making collodion. 

Pyroxylinum (Pyroxylin ; Gun-Cotton). 

Made by treating cotton-wool with sulphuric and 
nitric acids. It is explosive, and is soluble in a mix- 
ture of ether and alcohol. 

Collodium (Collodion). 

Made by dissolving pyroxylin in a mixture of stronger 
ether and stronger alcohol. When applied to the skin, 
after evaporation of the ether and alcohol, a colorless, 
transparent, contractile film is deposited, impervious 
to air and moisture. The vapor of collodion is in- 
flammable. 

Collodium Flexile. 
Flexible Collodion. 

Contains Canada turpentine and a small proportion 
of castor oil. The oil renders the film pliable, and 
prevents its contraction. 

Collodium Cantharidatum. 
Vesicating Collodion. 

Collodion containing a solution of cantharides, and 
used as a vesicant. The skin must be washed with 
the same precautions used in applying cantharides, and 
from three to five coats painted on with a brush, letting 
each dr}' separately. The action of the vesicating col- 
lodion is hastened by spraying with ether after applica- 
tion. 

Collodium Stypticum. 
Styptic Collodion. 

Contains tannic acid, ether, alcohol, and collodion. 



1 86 MATERIA MEDIC A FOR NURSES. 

Nat. Ord. Byttneriacece. 
Oleum Theobromatis (Oil of Theobroma). 
Cacao Butter. 

An oil expressed from the seeds of Theobroma cacao, 
the chocolate tree. It has the consistency of tallow, 
and melts at the temperature of the body. It does not 
become rancid, and is used as an unguent and in the 
preparation of suppositories. 

Nat. Ord. Rutacece. 

Buchu. 

The leaves of Barosma crenulata and other species 
of the same family, from Southern Africa. They con- 
tain volatile oil and a bitter extract. 

Buchu is slightly tonic, owing to its bitter principle. 
It is also a stimulating diuretic, and has some 
alterative power. 

Fluidextractum Buchu. 
Fluidextract of Buchu. 

Dose, Ti[ xxx., well diluted. (2 Cc.) 
Ruta (Rue). 

The leaves of Ruta graveolens, or garden rue. The 
active principle is a volatile oil, of hot and bitter taste. 
Rue is a carminative and emmenagogue. In large 
doses it is irritant and will cause abortion. It is less 
powerful than savine. 

Dose of the oil, Oleum Rutse, tt[. i.-iii. (0.06-0.2 
Cc.) 

Pilocarpus (Jaborandi). 

Jaborandi, if applied to the conjunctiva, causes con- 
traction of the pupil, with disturbances of vision. The 



THE VEGETABLE KINGDOM. 1 87 

effect is shown in about ten minutes, and in an hour or 
two after begins to pass off, disappearing entirely within 
twenty-four hours. Pilocarpine, or the preparations of 
jaborandi, enter the blood rapidly, and pass into the 
tissues. The most prominent action of the drug is that 
of a prompt and powerful diaphoretic and sialo- 
gogue. It is also a cardiac and motor depressant. 

When 60 to 90 grains of the infusion of jaborandi are 
given to an adult, after about ten minutes the face and 
neck are flushed, and salivation and perspiration set 
in. These symptoms may appear in five or six minutes 
after a hypodermic injection of the alkaloid. 

Perspiration begins on the face, and extends down- 
ward, lasts from three to five hours, and is profuse in 
the extreme, amounting to § ix.-xv., and becomes 
alkaline in reaction, if it is not so at first. The flow of 
saliva may equal | x.-xxv. It is sometimes the case 
that with profusion of one secretion there will be 
scantiness of the other. The secretions of the eyes 
and nose are stimulated. Sometimes nausea and 
vomiting are caused. The pulse is at first stimulated 
and quickened, but as diaphoresis goes on it becomes 
slow and weak. The respirations are lowered, and 
apncea may result from an increase in the mucus of the 
bronchial tubes. The temperature falls from i° to 4 , 
and a depressed condition results, with pallor, chilli- 
ness, and general weakness, lasting several hours. 

The pupils are contracted, and vision impaired. 

Jaborandi, in small doses, is diuretic, and increases 
the elimination of urea. 

The patient undergoing the diaphoretic action of 
jaborandi should be placed between blankets, and the 
depression is to be combated by external heat, which 
also assists the diaphoretic action of the drug. Within 
three to six hours the effects have passed away. 

Children bear relatively larger doses without harm 
than do adults. 

(Edema of the lungs is the untoward effect most to 
be dreaded in giving pilocarpine. A person literally 
drowns himself with his own sweat at times. 



1 88 MATERIA MEDICA FOR NURSES. 

Preparations. 

Fluidextractum Pilocarpi. 
Fluidextract of Pilocarpus. 

More certain in action, less nauseating and disagree- 
able to take than the infusion of jaborandi, which was 
formerly used. Dose TT[ xv.-3i. (""I x. = gtt. xx.). 
(1-4 Cc.) 

Pilocarpine Hydrochloridum. 
Pilocarpine Hydrochloride. 

A solution for hypodermic use. Dose, gr. \-\. 
(0.008-0.02 Gm.) 

Nat. Ord. Simarubacece . 

Quassia. 

The wood of Picr<zna excelsa, a tree of Jamaica. 

The active principle, quassin, is an intensely bitter 
neutral substance. 

Quassia is one of the most active of simple bitters 
and stomachics. It contains no tannin, and is there- 
fore not incompatible with iron. 

An infusion of quassia used as an enema is anthel- 
mintic. 

Preparations. 

Tinctura Quassiae. 
Tincture of Quassia. 

Strength, 20$. Dose, 1U xx.- 3 i. (1.3-4 Cc.) 

Fluidextractum Quassiae. 
Fluidextract of Quassia. 

Dose, Til v.-x. (0.3-0.65 Cc.) Both preparations 
to be diluted rather freely and given before meals. 



THE VEGETABLE KINGDOM. 1 89 

Nat. Ord. Rhamnacece. 
Rhamnus Purshiana; Cascara Sagrada. 
Sacred Bark ; California Buckthorn. 

The bark of Rhamnus purshiana. 

Cascara in small doses is tonic and stomachic ; in 
large dose, laxative or cathartic, with active and 
certain effect. It sometimes causes griping pain. 

Fluidextractum Rhamni Purshianae. 
Fluidextract of Cascara. 

May be given at night, or one or two hours after 
meals. Dose, at night, 3 ss.; after meals, 1U x.-xv., 
well diluted. (0.65-2 Cc.) 

Cascara is now used in greater quantity than any 
other drug in the pharmacopcea. It is pleasantly lax- 
ative and may be used year in and year out without 
losing its specific effect, and without fear of harm to the 
individual. Usually ten to twenty drops at night in 
a little water is the best manner of taking it. Its 
effectiveness varies with the individual, and one should 
determine what is the proper dose by trial. 

Nat. Ord. Amyridacece. 
Myrrha (Myrrh). 

A gum resin which exudes from the stem of a species 
of balsam. Tincture of myrrh, like other oleo-resins, 
is mildly stimulant and disinfectant, and is useful in 
making mouth washes for the sick. 

It has some action as a stomachic, and in certain 
cases aids the action of purgatives. It is also a uterine 
stimulant and emmenagogue. 

Nat. Ord. Leguminosce. 

Tragacantha (Tragacanth). 

A gum resin which exudes from the stem of Astra- 
galus gummifera\ used to make a demulcent drink. 



I90 MATERIA MEDICA FOR NURSES. 

Scoparius (Broom-Tops). 

The fresh and dried tops of Cystisus scoparius, of 
Europe and the United States. They contain two 
active principles, scoparine and sparteine. Scoparius 
is an excellent diuretic. 

Dose of the infusion, § i. 

Sparteine Sulphas. 
Sparteine Sulphate. 

A liquid alkaloid obtained from scoparius. It is 
colorless, with bitter taste, and with sulphuric acid 
forms a crystalline salt, which is soluble in water. 

Physiological Actions. 

Sparteine is slightly hypnotic, but is more impor- 
tant as a cardiac stimulant, increasing the force and 
regularity of the pulse. It acts very quickly, its influ- 
ence over a weak, failing heart being shown within 
half an hour to one hour, but it does not last long, 
wearing off in four or five hours. 

It is not considered equal to digitalis, but it is often 
given with it and with other more enduring but slowly 
acting stimulants. It is not accumulative, and does 
not disturb digestion nor impair the appetite. 

It has not the diuretic action of scoparius. In larger 
doses it is a depressant to the brain and spinal cord, 
and causes death by paralysis of the respiratory centre. 
Doses of four to six grains produce vertigo, headache, 
palpitations, and a feeling of formication in the 
extremities; and large doses have caused loss of power 
in the legs, sensations of heat, with flushed face and 
severe pain about the heart, the symptoms beginning 
in about twenty minutes and reaching their climax in 
four or five hours. 

Dose, gr. ^-\\. (0.003-0.1 Gm.) 

Copaiba. 

The oleo- resin of a species of Brazilian tree. It is 
stimulating to mucous membranes, as those of the 



THE VEGETABLE KINGDOM. 191 

bronchi and alimentary canal. It is also a stimulant 
diuretic of somewhat irritating character. It is stated 
that its use has been followed in some instances by 
strangury and in others by suppression of urine. 

Dose, rn, x.-xx. (0.65-1.3 Cc), on sugar, or made 
into an emulsion with syrup and gum arabic. 

Glycyrrhiza (Licorice-Root). 

The root of Glycyrrhiza glabra, cultivated in Eng- 
land. 

Licorice is demulcent. It contains grape-sugar, 
starch, resin, and a glucoside named glycyrrhizin. 

Pulvis Glycyrrhizae Compositus. 
Compound Licorice Powder. 

A laxative preparation containing senna, licorice- 
root, fennel-sugar, and sulphur. Its action resembles 
that of castor oil. It is not a hydragogue cathartic, 
and given in moderate doses causes no griping, and 
acts gently — in the morning if given at night; in from 
three to six hours if given early on an empty stomach. 
Many patients find it nauseous; it is therefore best to 
make the dose small as possible by diluting it only a 
little and giving afterwards a larger quantity of water. 

Dose, 3 i.-iv. (4-16 Gm.) 

Balsamum Peruvianum (Balsam of Peru). 

A balsam exuded from the trunk of Toluifera 
pereircz. It is a reddish-brown or nearly black liquid, 
thick and syrupy, and insoluble in water. It contains 
benzoic acid, a number of resinous principles, a volatile 
oil, and other constituents. 

It is a vascular stimulant and nerve sedative, 
antiseptic, and disinfectant, and is used externally 
as an application to stimulate granulating surfaces. It 
is not used internally, though it has mild action as a 
carminative and as a stimulant and disinfectant 
expectorant. 



192 MATERIA MEDIC A EOR NURSES. 

Balsamum Tolutanum (Balsam of Tolu). 

Balsam of tolu is obtained from the trunk of Tolui- 
fera balsamum. It is a reddish-yellow, soft, sticky 
substance of fragrant odor, soluble in alcohol. It 
yields benzoic and cinnamic acids, various resins, etc. 
Its properties are the same as those of balsam of Peru; 
but it is only used internally as an ingredient of cough 
mixtures. 

Physostigma (Calabar Bean). 

The dried seeds of Physostigma venenosum, an 
African plant. They contain two alkaloids: cala- 
barine, the less important one; and physostigmine, or 
eserine, the active principle. 

Physiological Actions. 

Applied to the eye, pysostigmine is absorbed by the 
conjunctiva, and causes contraction of the pupil, with 
slight twitching of the eyelids, dimness of vision, and 
pain over the eyes. 

Calabar bean acts as a depressant on the medulla and 
spinal cord, but does not affect the cerebrum, the mind 
remaining clear in cases of poisoning. In moderate 
doses it sometimes produces nausea, colic, and in- 
creased peristaltic motion, resulting in diarrhoea. 

The heart is first stimulated, and then weakened, 
and the same contraction of the pupil takes place after 
its internal use. 

Symptoms of Poisoning. 

The first symptoms of poisoning are: giddiness, 
weak pulse, muscular feebleness, vomiting, and free 
purging. The respirations become slow and irregular, 
and death results from paralysis of the respiratory 
centre. 

The poison is treated by emptying the stomach, 
applying external heat, and using artificial respiration. 



THE VEGETABLE KINGDOM. 193 

Atropine is a physiological antagonist, and is given in 
doses not larger than gr. T V- 

Recovery has taken place, by means of prompt 
emesis, after a dose of gr. xii. 

Preparations. 

Extractum Physostigmatis. 
Extract of Physostigmine. 

Dose, gr. ^-J. (0.006-0.012 Gm.) 

Tinctura Physostigmatis. 
Tincture of Physostigmine. 

Dose, TTj, v.-xv. (0.3-1 Cc.) (iTl x. = gtt. xiv.) 

Physostigmine Sulphas. 
Physostigmine Sulphate. 

Dose, gr. gV-tV (0.001-0.004 Gm.) 

Tamarindus (Tamarinds). 

The preserved pulp of the fruit of Tamarindtis 
indica. Tamarinds are laxative, and are taken like 
preserves, or made into confections with senna. 



Senna. 

The dried leaflets of two varieties of Cassia, from 
Africa and Arabia. The active principle is cathartic 
acid, and there are other unimportant principles. 

Senna is a simple cathartic, and acts as a stimulant 
to the muscular coat of the intestines, producing local 
reflex action, active peristalsis, and free evacuations 
within four or five hours. It acts especially on the 
colon, and does not cause constipation after its action 
is over. Griping pains are caused by full doses, but it 
is usually given in combination for the purpose of 
avoiding this. 

J 3 



194 MATERIA MEDIC A FOR NURSES. 

Senna is excreted by the kidneys and the mammary 
glands. Nursing infants in this way feel its action as 
a laxative. 

Senna is especially valuable as a laxative for child- 
ren and may be given in the form of senna tea made 
with a teaspoonful of the senna leaves over which a 
teacupful of boiling water is poured and allowed to 
stand a short while. 

Preparations. 

Fluidextractum Sennae. 
Fluidextract of Senna. 

Dose, 3 ss.-ii. (2-8 Cc.) 

Confectio Sennae. 

Tamar-Indien. 

Tropical Fruit Laxative. 

This preparation tends to disorder the digestion. 
Dose, 3i.-ii. (4-8 Gm.) 

Infusum Sennae Compositum. 
Black Draught. 

Contains manna and sulphate of magnesium, and is 
an active hydragogue purgative. Dose, f iv. (120 
Cc.) 

Syrupus Sennae. 
Syrup of Senna. 

Dose 3 ss.-ii. (2-8 Cc.) 

Nat. Ord. Rosacea. 

Amygdala Amara (Bitter Almond). 

The ripe seeds of Primus amygdalus, the bitter 
almond tree. The important principle of the bitter 
almond is a volatile oil, which contains from 4 to 8 % 
of hydrocyanic acid, and is highly poisonous. 

The artificial oil of bitter almonds, nitro-benzene, 
or nitro-benzol, is poisonous, and has caused death. 



THE VEGETABLE KINGDOM. 1 95 

Rubus (Blackberry). 

The bark of the root of Rubus villosus and other 
varieties of rubus. An astringent, containing 10 $ of 
tannin. 

Dose of the fluid extract, Tft x.-3 i. (0.65-4 Cc); 
of the syrup, 3 i.-§ i. (4-32 Cc.) 

Prunus Virginiana (Wild Cherry). 

The bark obtained from Prunus serotz'na, or wild 
cherry tree, contains tannic acid, a bitter extractive, 
amygdalin, and emulsin, and these two latter princi- 
ples, when brought into contact in watery solution, 
produce hydrocyanic acid. 

The effect of cherry bark, as administered, is due to 
the tannic and hydrocyanic acids and the bitter ex- 
tractive. None of these, however, are present in 
sufficient amount to make a strong impression, and the 
only physiological action is that of a mild astringent 
and tonic. The syrup of wild cherry bark is much 
used as the basis of cough mixtures. There is also a 
fluid extract given in doses of 3ss.-3i. (2-4 Gm.) 

Nat. Ord. Myrtacece. 
Eucalyptus (Blue Gum Tree). 

The blue gum tree, Eucalyptus globulus, is found in 
southern countries. From a hygienic point of view it 
is unusually interesting. It has an enormous capacity 
for absorbing water from the soil. One tree, it is said, 
will absorb in twenty-four hours ten times its weight 
of water. Swamps are therefore drained and trans- 
formed into dry land by planting the eucalyptus. It 
is also believed that it purifies the air of malarial dis- 
tricts by absorbing poisonous emanations and by giving 
forth balsamic principles. 

It is largely cultivated in southern malarial locali- 
ties; for instance, in the Roman Campagna, portions 
of which it has transformed into habitable regions. 



Ic/> MATERIA ME DIC A FOR NURSES. 

The leaves only are official. They yield tannic acid, 
the principles turpene, cymol, eucalyptol, and others. 

Physiological Actions. 

It is tonic to appetite and digestion, and stimulates 
all the juices of the alimentary tract. It is destructive 
to low forms of life, antimalarial, diaphoretic, and 
a stimulant expectorant. It is eliminated by the 
skin, mucous membranes, and kidneys. It is given 
when quinine cannot be administered, its effect being 
much the same. In excessive doses, symptoms similar 
to those caused by overdosing with quinine appear, as 
headache, palpitations, and numbness of the limbs. 

Preparations. 

Oleum Eucalypti. 
Oil of Eucalyptus. 

The essential oil, which is the active principle of the 
drug. Dose, TT[ v.-x., in emulsion or capsule. (0.3- 
0.65 Cc.) 

Fluidextractum Eucalypti. 
Fluidextract of Eucalyptus. 

Dose, m x.-3 i. (0.65-4 Cc.) 

Granatum (Pomegranate Rind). 

The bark of the pomegranate root contains four 
alkaloids, of which the two most important are pel- 
letierine and isopelletierine. The drug is an efficient 
taeniacide, or remedy for tapeworm. It is capable of 
causing symptoms of some severity, such as muscular 
depression almost amounting to paralysis, and it is not 
considered a safe drug for children. The taste is very 
unpleasant. In administration the patient fasts for 
twelve or eighteen hours previously to taking the dose. 
The decoction of the fresh root is used in a strength of 
two ounces to a pint of water. This quantity is divided 
into several doses, and taken at intervals of an hour. 



THE VEGETABLE KINGDOM. 1 97 

Pelletierine is given in the same way. A cathartic is 
given afterwards, no food being allowed until the treat- 
ment is over. 

Pelletierinae Tannas. 
Pelletierine Tannate. 

Dose of pelletierine tannate, gr. iv.-x. (0.25-0.65 
Gm.) 

Caryophyllus (Cloves). 

The unopened flowers of Eugenia aromatica, a tree 
of the Molucca Islands. The spice made from them 
contains oleum caryophyllae, or oil of cloves, a 
pungent, volatile oil. It is aromatic and carmina- 
tive, and locally to some extent anaesthetic, as shown 
by its popular use in the cavity of an aching tooth. 
Clove tea is made with spice and boiling water, 3 
ii.-O.i. 

Jambul. 

The drug obtained from the bark of Eugenia jam- 
bolana, an Bast Indian tree, is used in India as a 
stomachic astringent, and also as a specific in 
diabetes. 

Dose of the fluid extract, ttj, x.-xxx. (0.65-2 Cc.) 

Nat. Ord. Cucurbitacecz. 
Colocynthis (Colocynth). 

The dried, peeled, and seeded fruit of Citrullus 
colocynthis, or bitter cucumber, from Eastern coun- 
tries. The active principle is colocynthin. 

Colocynth is a powerful hydragogue and drastic 
cathartic, irritant, and quickly acting, causing large 
watery evacuations, with griping pains and general 
depression. Besides acting as a stimulant to the 
muscular coat of the intestines, it also acts on the in- 
testinal glands and on the liver. To avoid the severity 
of its effects, it is always given in combination, and is 



I98 MATERIA MEDIC A FOR NURSES. 

not suitable as an habitual purgative, being irritant to 
the stomach as well as to the bowels. 

Gastro-enteritis is caused by colocynth in poisonous 
quantity, and death has resulted in twenty-four hours 
from a dose of 3 i-— 3 iii. of the powder. 

Preparations. 

Extractum Colocynthidis. 
Extract of Colocynth. 

Purgative dose, gr. \-i. (0.018-0.065 Gm.) 

Extractum Colocynthidis Compositus. 
Compound Extract of Colocynth. 

Contains extract of colocynth, aloes, scammony, and 
cardamom. 

Laxative dose, gr. i.-iii. (0.06-0.2 Gm.) 
Purgative dose, gr. v.-xx. (0.3-1.3 Gm.) 

Pilulae Catharticae Compositae. 
Compound Cathartic Pills. 

Contains extract of colocynth, mild mercurous 
chloride, extract of jalap, and gamboge. 

Pilulae Catharticae Vegetabiles. 
Vegetable Cathartic Pills. 

Contain compound extract of colocynth, extract of 
hyoscyamus, jalap, leptandra, and resin of podo- 
phyllum. 

Elaterinum (Elaterium ; Squirting Cucumber). 

Blaterium is a sediment obtained from the juice of 
Ecballium elaterium, from Greece, and cultivated in 
England. It contains a neutral active principle, 
elaterin, which is the official preparation, elaterium 
being of variable strength. 

The most active hydragogue cathartic known, 
producing excessive watery evacuations in a very 
short time. If the dose is not too large there is little 
or no pain or irritation, although in excess it is a 



THE VEGETABLE KINGDOM. 1 99 

gastrointestinal irritant. It is also irritant if applied 
to the skin. The purgative action of elaterium is 
exhausting, and the condition of the patient must be 
watched. Catharsis is also produced when it is in- 
jected hypodermically, but it cannot be safely used in 
this way, as it is very irritant to the tissues, and has 
been followed by tetanus. 

Preparations. 

Elaterium. 

Dose, gr. }. (0.01 Gm.) 
Elaterinum. 
Elaterin. 

Dose, gr. -fa. (0.003 Gm.) 
Trituratio Elaterini. 
Trituration of Elaterin. 

Strength, 1 to 10. Dose, gr. ss. (0.03 Gm.) 

Pepo (Pumpkin Seeds). 

The seeds of Cucurbita pepo, or ordinary pumpkin, 
are useful as a remedy for tapeworm, being considered 
more efficient than Felix mas, and quite harmless. 
The dose of the expressed oil is half an ounce, given 
in three doses on an empty stomach, the patient having 
fasted on the day before; or two ounces of the seeds 
may be beaten into an emulsion with sugar and water 
and taken with the same precaution. A cathartic 
follows. 

Nat. Ord. Umbellifercz. 

Conium (Spotted Hemlock). 

The fruit and flowers of Conium maculatum, belong- 
ing to Europe and naturalized in the United States. 
They have an odor resembling that of mice. The 
active principle is conine, a very volatile alkaloid, 
freely soluble in alcohol and ether, and slightly so in 
water. On exposure to the air it decomposes, and 
this change is assisted by heat. 



200 MATERIA MEDICA FOR NURSES. 

Physiological Actions. 

Conium is a motor depressant, paralyzing the motor 
nerves from below upward. It affects the respiratory 
centre, paralyzing it. The cardiac and vascular cen- 
tres are not specially influenced. The brain is not 
affected, but remains clear. 

When conium is taken in doses just large enough to 
make an impression, the first effect noticed is muscular 
weakness in the legs. The feet feel weighted down, 
or as if made of lead; the knees weak and unable to 
bear the body, giving an intense desire to lie down, 
and the patient cannot walk, but staggers and falls. 

The eyelids are affected and drop over the eyes; the 
vision is disordered, and there is frontal headache, 
with a feeling of heat, or of weight and pressure, in 
the head. 

Conium is used as an antispasmodic ; also some- 
times as an analgesic, and as a calmative in condi- 
tions of hysterical and maniacal excitement. It is well 
borne by children. 

Symptoms of Poisoning. 

In serious poisoning the symptoms mentioned above 
are all intensified. The pupils dilate; the pulse, at 
first diminished, afterwards becomes more rapid. The 
respiratory centre is paralyzed, and death results from 
asphyxia in a very short time — in one case in a few 
moments. There are but few recorded cases of fatal 
poisoning. Hemlock was the State poison of Athens 
in the time of Socrates, and the means of his death. 

Treatment of Poisoning. 

No physiological antidote to conium is known. The 
stomach must be emptied and tannic acid given, stim- 
ulants employed and external heat applied, and arti- 
ficial respiration practised as long as there is any heart 
action. 



THE VEGETABLE KINGDOM. 201 

Preparations. 

Fluidextractum Conii. 
Fluidextract of Conium. 

The best preparation. Dose, TH, i.-ii. (0.06-0.12 
Cc.) 

Conine. 

Dose, tt| T V-iii.; or gr. -^"tV (0.001-0.006 Gm.) 

Asafoetida. 

A gum resin obtained by incising the root of different 
species of Ferula, of Afghanistan. It contains a vola- 
tile oil, a resin, and gum. The oil is complex, but 
consists largely of the essential oil of garlic, to which 
it owes its unpleasant odor. The resin also yields 
sulphur. 

Physiological Actions. 

Asafoetida has, in the stomach and alimentary canal, 
the stimulant and disinfectant action belonging to 
volatile oils and resins; but, while most others are 
pleasant to the taste, it is exceedingly nauseous and 
disagreeable. The mental influence of this nauseous 
impression, combined with its physiological action, 
renders asafoetida a nerve stimulant, antispasmodic, 
and calmative in hysterical conditions. 

It is a carminative, and in enemata dispels gas, 
stops convulsions, and relieves constipation. It has 
some slight action as a stimulant and disinfectant 
expectorant. The volatile oil is excreted by the 
urine, perspiration, and breath. 



Preparations. 

Pilulae Asafcetidae. 
Pills of Asafoetida. 

Gr. iii. in each. Dose, ii.-iv. pills. 



202 MATERIA MEDIC A FOR NURSES. 

Mistura Asafcetidse. 
Milk of Asafcetida. 

Dose, § ss.-i. For use in enemata, 1 i.-iii. 

Tinctura Asafcetidae. 
Tincture of Asafcetida. 

Strength, 20 f . Dose, T\[ v.-xx. (0.3-1.3 Cc.) 

Nat. Ord. Caprifoliacece. 
Viburnum Prunifolium (Black Haw). 

Viburnum acts upon the nerve centres of the uterus 
and ovaries as a sedative and tonic, and is given to 
correct pain and irritation arising from these sources. 

Viburnum opulus is useful in the same way. 

Dose of the fluid extract, tt[ xx.- 3 i. (1.3-4 Cc.) 

Nat. Ord. Rubiacece. 
Cinchona. 

The trees belonging to the genus Cinchona are found 
native in South America, on mountains at a height of 
5000 to 10,000 feet, and they are being successfully 
cultivated in other countries. The bark is the part 
used in medicine. 

There are many varieties of the tree, the most im- 
portant being Cinchona succirubra, from which "red 
bark" is obtained, and Cinchona calisaya, from which 
comes the " yellow" or "calisaya bark." A bark 
called "pale bark" is obtained from two minor vari- 
eties, and, finally, under the general name "cinchona" 
or "Peruvian bark" are included all other varieties of 
the tree yielding two or three per cent, of the alkaloids 
which contain crystallizable salts. 

Cinchona contains four principal alkaloids: quinine, 
the most important; quinidine, the strongest anti- 
periodic, but existing in very small quantities; cincho- 
nine, about half the strength of quinine; and cinchoni- 
dine, a little stronger than cinchonine. 



THE VEGETABLE KINGDOM. 203 

The yellow bark contains most quinine, the pale 
bark most cinchonine, and the red bark about equal 
quantities of each. Besides these important alkaloids 
and a number of unimportant ones, cinchona bark 
contains tannic and other acids, a resinous substance, 
coloring matter, etc. 

Physiological Actions. 

The preparations of cinchona bark as a whole are 
used as bitter stomachics and tonics. 

They are too bulky to be used as antipyretics or 
antiperiodics if quinine can be obtained. They have 
some astringent action, due to the tannin they 
contain. 

Preparations. 

Tinctura Cinchonae. 
Tincture of Cinchona. 

Strength, 1 to 5. Dose, 3 i.-ii. (4-8 Cc.) 

Tinctura Cinchonae Composita. 
Huxham's Tincture. 

Contains cinchona, glycerin, bitter orange-peel, 
serpentaria, and alcohol. Dose, 3 i.- J ss. (4-16 
Cc.) 

Fluidextractum Cinchonae. 
Fluidextract of Cinchona. 

Dose, TTt v.-xv. (fTl x. = gtt. xx.). (0.3-1 Cc.) 
The preparations of cinchona are given half an hour 
before meals. 

Quinina (Quinine). 

Quinine is prepared from the powdered cinchona 
bark by various chemical processes, in the course of 
which an alkali and sulphuric acid are both used. 

Alkalies, and their carbonates, and tannic acid are 



204 MATERIA MEDICA FOR NURSES, 

incompatible with quinine and the other alkaloids of 
cinchona. The alkalies precipitate them from solution, 
and tannin forms with them insoluble compounds. 
One grain of dilute sulphuric acid will dissolve one 
grain of quinine. 

Physiological Actions. 

Quinine arrests some processes of fermentation and 
decomposition, and might, except for its cost, be used 
as a local antiseptic and disinfectant. It is readily 
absorbed, and is frequently given by rectum ; it is also 
used hypodermically, though it is very irritating and 
liable to produce abscesses. 

In small doses it is a powerful bitter stomachic and 
general tonic, stimulating digestion and increasing 
appetite. In large doses it may irritate and cause 
nausea and vomiting, or even gastritis. 

Quinine may be found in the blood a few minutes 
after being taken, and retards oxygenation. It enters 
the tissues quickly and is excreted slowly, several 
days being required. The maximum effect of a large 
dose is reached in about five hours. Small doses 
quicken the heart and raise the blood pressure. Large 
ones depress the heart, diminish the force and fre- 
quency of its contractions, and lower blood pressure. 
The respirations are also depressed by large doses. 

Quinine acts strikingly on the nerve centres. Small 
doses stimulate the brain and increase the activity of 
the mind, while slight overdoses produce headache 
and ringing in the ears, with deafness, more or less 
pronounced. This deafness usually passes off quickly, 
but may be permanent. Full doses intensify these 
symptoms, and cause severe pain, constriction, and 
fulness in the head, confusion of the mental faculties, 
intense nervous irritability, giddiness, disorders of 
vision, and general prostration from depression of the 
spinal cord and circulation. 

The pre-eminent power of quinine is shown in its 
control over malarial poisoning as a specific, anti- 
periodic, and prophylactic. (A medicine to be pro- 



THE VEGETABLE KINGDOM. 20$ 

phylactic must belong either to the class of restoratives, 
supplying a deficiency of some natural and essential 
condition of the body, or to the class of germicides, 
preventing disease by destroying the injurious agent.) 
Quinine has some power as an oxytocic, contracting 
the uterus. In times past it was taught that it was 
capable of producing abortion, but the weight of evi- 
dence is believed by most authorities to be against this 
theory. 

Incidental Effects. 

Eruptions of the skin are sometimes observed after 
the use of quinine, even in small doses. A rash re- 
sembling that of scarlet-fever may appear, followed by 
severe itching and smarting, and desquamating finally. 

More rarely the eruption resembles urticaria, popu- 
larly known as "hives " or "nettle-rash." Occasionally 
irritation of the urinary organs is caused, with pain, 
congestion of the kidneys, or even hemorrhage. This 
is more liable to occur with old people. Idiosyncrasy 
exists in a marked degree with some persons in 
regard to quinine, forbidding the use of even the 
smallest doses. 

If much prostration follows the administration of 
quinine, strong black coffee with brandy is the best 
antidote. In giving quinine, ringing in the ears and 
deafness are the first symptoms to be looked for. 

Quininae Sulphas. 
Quinine Sulphate. 

Usually given in pills or capsules on account of the 
bitter taste. Sometimes, when rapid action is desired, 
it is given in solution. The taste is very persistent 
and is better removed by a piece of dry bread, or an 
olive, than anything else. The powdered sulphate 
may be given in sherry wine. 

.Quinine pills should not be more than ten days old, 
as then they become so dry and hard as to be useless, 
passing through the alimentary canal without dissolv- 
ing. Quinine should be given on an empty stomach, 



206 MATERIA MEDICA FOR NURSES. 

or after the process of digestion is partly over. If a 
patient is on milk diet quinine should not be given in 
solution near the milk, as it is very liable to cause 
vomiting. Otherwise there is no incompatibility be- 
tween quinine and milk. 

Quinine sulphate is made readily soluble by adding 
sufficient quantity of dilute sulphuric acid to the 
solution. 

Tonic dose, gr. i.-v. (0.06-0.3 Gm.) 

Antipyretic or antiperiodic dose, gr. x.-xxx. (0.6-2 
Gm.) 

Warburg's Tincture. 

A preparation with an exceedingly long formula, 
containing over a dozen drugs of vegetable origin, with 
a certain proportion of quinine, the most active in- 
gredient (between 9 and 10 grains to the ounce). It is 
used as a diaphoretic, and is best given at night. 

Dose, 1 ss. (16 Cc.) 

Ipecacuanha (Ipecac). 

The dried root of Cephaelis ipecacuanha, of Brazil. 
Ipecac contains from \ to 1 % of the active principle, 
emetine, and also a glucoside, starch, gum, etc. 

Physiological Actions. 

Externally, powdered ipecac irritates the skin, caus- 
ing a pustular eruption. Mucous membranes are 
similarly irritated, and an increased bronchial and 
nasal secretion, sneezing, etc., follows its local applica- 
tion. Taken internally, it tends to soften and liquefy 
hard and tenacious mucous secretions. 

In the stomach ipecac in very small doses (gr. J) is 
a gastric stimulant, increasing local circulation and 
secretion. In these minute doses it checks vomiting. 

In large doses it is a familiar emetic, safe and 
prompt, and non- depressing. Its action is partly 
direct and partly indirect, the act of vomiting being 
promoted both by local action on the stomach walls, 



THE VEGETABLE KINGDOM. 207 

and by stimulation through the influence of emetine of 
the vomiting centre in the medulla. 

The emesis caused by ipecac takes place in from 
twenty to thirty minutes after administration, and 
occurs usually only once. There is but very little 
nausea before or with the act of vomiting, nor is it 
followed by exhaustion. It is accompanied by a 
decided increase in the secretions of the gastric and 
bronchial mucous membranes, and, the sputum thus 
being made more fluid, with the expulsive act there is 
a general clearing out of the bronchial tubes, the 
trachea, and the nasal cavities. 

Ipecac, as an emetic, is between sulphate of zinc and 
tartar emetic, not being as prompt as the first, nor as 
nauseating as the second. It is not powerful enough 
to give alone in cases of poisoning, but is then used as 
an aid to other emetics. It is very suitable for child- 
ren, and they bear it in relatively large doses. 

Ipecac is a sedative expectorant, a direct chol- 
agogue, increasing the flow of bile, and a diaphoretic. 

Preparations. 

Pulvis Ipecacuanhae. 
Powdered Ipecac. 

Dose, gr. xx. (1.3 Gm.) 

Syrupus Ipecacuanhae. 
Syrup of Ipecac. 

Strength, 7 parts fluid ext. to 100. Dose for infant, 
3 ss.-ii. (2-8 Cc.) 

Vinum Ipecacuanhas. 
Wine of Ipecac. 

Strength, 1 part fluid ext. to 8 white wine. Dose, 
Til x.-xx. (0.65-1.3 Cc.) 

Fluidextractum Ipecacuanhae. 
Fluidextract of Ipecac. 

Emetic dose for adult, tt[ xv. (ni x. = gtt. xx.) 
(1 Cc.) 



208 MATERIA MEDIC A FOR NURSES. 

Emetine. 

Dose, gr. |— £. (0.01-0.03 Gm.) 

All these preparations are best given with plenty of 
warm water, in cases of poisoning; with croupy child- 
ren, however, swallowing being difficult, it is best not 
to dilute the dose, or but very little. 

Coffea Arabica (Coffee Plant). 

The seeds of the coffee plant, grown in Arabia, yield 
the alkaloid caffeine (which is also obtained from 
plants belonging to different families, viz., Paullinia 
sorbilis, guarana). The coffee seeds also contain 
sugar, tannic acid, caffeic acid, a volatile oil, etc. 

The qualities of coffee as a beverage are too familiar 
to need mention. In moderation, and when well made, 
it aids digestion and has laxative effect. In excess, 
or when improperly made and allowed to boil, it 
causes dyspepsia by the astringent action of its tannic 
acid. 

Caffeina. 
Caffeine. 

Caffeine is distinguished by containing more nitrogen 
than almost any other vegetable principle. It is 
absorbed unchanged into the circulation, and is a 
stimulant to the brain and heart, producing wakeful- 
ness, with a clear, vigorous state of the intellect, and 
strengthening the contraction of the heart. 

It resembles digitalis in its action as a cardiac stimu- 
lant, but acts more promptly and is more transitory in 
its effects. 

It has no decided cumulative tendency, and does not 
disagree with the stomach. It acts as a diuretic by 
stimulating the cells of the kidneys, as well as by its 
action on the heart and circulation. 

It has been known to cause, after doses of moderate 
size, nervous wakefulness and restlessness, tremulous- 
ness, frequent pulse, confused thought, and visions 



THE VEGETABLE KINGDOM. 209 

passing in a constant train. These symptoms have 
lasted for several hours. 

In large doses it has caused poisonous though never 
fatal symptoms, such as muscular tremor, a burning 
feeling in the throat, palpitations with rapid, violent 
pulse and short, quick respirations; giddiness, nausea, 
disordered vision, and marked diuresis. 

Dose of caffeine, gr. \-\\. (0.03-0.12 Gm.) 

Nat. Ord. Ternstromiacece . 
Camellia Thea (Tea Plant). 

The leaves of the tea plant, grown in China, contain 
theine, the active principle; tannic acid, and a volatile 
oil. Theine was formerly considered to be identical 
with caffeine, but investigators have recently pro- 
nounced them to be different. 

Tea is stimulating and refreshing. Used to excess 
it weakens the digestive system and causes constipa- 
tion, depresses the heart and vaso-motor nerves, pro- 
ducing neuralgic pains. In cases of poisoning, when 
tannin is needed, it may sometimes be most quickly 
procured in the form of strong, rank tea. By boiling 
it hard and squeezing dry the leaves, the tannin is 
extracted as thoroughly as possible, and the tea is 
given, without sugar or milk, in large quantities. 

Nat. Ord. Valerianacece . 
Valeriana (Valerian). 

The dried rhizome and roots of Valeriana officinalis. 
The active principles are a volatile oil and valerianic 
acid. The latter is found in many other plants, in 
cod-liver oil, and may be derived from amylic alcohol. 

Valerian is a carminative, circulatory stimulant, 
and antispasmodic. In nervous cases it sometimes 
acts successfully as an hypnotic. Large doses ( 3 ii.- 
iv.) may cause nausea, vomiting, and colic, a quick- 
ened pulse, and a feeling of formication in hands and 
feet. 



210 MATERIA MEDIC A FOR NURSES. 

Preparations. 

Tinctura Valerianae. 
Tincture of Valerian. 

Strength 20 <f . Dose, 3 i.-iii. (4-12 Cc.) 

Fluidextractum Valerianae. 
Fluidextract of Valerian. 

Dose, 3 i. (4 Cc.) 

Tinctura Valerianae Ammoniata. 
Ammoniated Tincture of Valerian. 

Strength, 20 $. Dose, 3 J-i. (1-4 Cc.) 

Nat. Ord. Composite. 
Santonica (Levant Wormseed). 

The dried flower-heads of Artemisia pauciflora, of 
Asia Minor. The active principle is santonin, and 
there is also a compound volatile oil resembling cam- 
phor in its action. 

Santonin is an anthelmintic, acting especially on 
the ascaris lumbricoides, or round worm. In overdoses 
it produces disturbances of vision and of consciousness. 
Objects appear at first to be blue, then yellow. There 
are tremors, aphasia, and sometimes convulsions. The 
respirations become feeble, and the pulse is reduced. 

It is necessary, in giving it, to watch its action, that 
these symptoms may be avoided. 

It is excreted by the bowels and by the kidneys, and 
discolors the urine, making it saffron or reddish. 
There have been numerous cases of fatal poisoning 
among children from santonin. Alarming symptoms 
have been caused by gr. ii. in a child eight years old, 
and a dose of gr. ii. to a child of five years caused 
death. 

Santoninum. 
Santonin. 

Dose, gr. J-v. (0.015-0.3 Gm.) 



THE VEGETABLE KINGDOM. 211 

Eupatorium (Thoroughwort). 

The herbal parts of a coarse plant yield this drug, 
whose chief action is as a sudorific. The infusion is 
given very hot, in doses of one half or one tumbler full, 
the patient being warmly covered in bed, and free 
diaphoresis results. The taste is very unpleasant. 

Taraxacum (Dandelion). 

The root of the dandelion is a simple bitter and 
mild laxative. 

Fluidextractum Taraxaci. 
Fluidextract of Taraxacum. 

Dose, 3 i.-ii., after meals. (4-8 Cc.) 
Arnica. 

The Arnica montana, or leopard's bane, grows in 
Northern Europe and Asia and in the Northwestern 
United States. The root and flowers contain two 
alkaloids and the ammonia compound, trimethylamine, 
which is found in cod-liver oil and in ergot, and may 
also be obtained from various decomposing albuminous 
substances. , 

Externally arnica is stimulating and irritant, 
increasing the circulation of the skin. It sometimes 
causes excessive redness, and eczema, and must be used 
with care. 

The diluted tincture promotes the absorption of 
blood which has effused into the tissues, as after a 
blow, and prevents swelling. 

Internally, in small doses, arnica is slightly stimulat- 
ing to the heart, the skin, and kidneys. 

In larger doses it is a cardiac depressant, and in 
doses equal to | i. of the tincture it has caused the 
poisonous symptoms of gastro-intestinal irritation; 
cold dry skin; feeble fluttering pulse, lowered some- 
times to 60; and occasionally vomiting and purging, 
with final collapse. It should never be applied to an 
open wound. 



212 MATERIA MEDIC A FOR NURSES, 

Preparations. 

Tinctura Arnicae. 
Tincture of Arnica. 

Strength, 20 #. . 

This preparation used externally must be diluted, 
applied on a piece of flannel to the inflamed part, and 
covered with a bandage. 

Dose, ttj, v.-xxx. (ni x. = gtt. xv.). (0.3-2 Cc.) 

Grindelia. 

The leaves and flowering tops of a California plant. 
It is a stimulant expectorant and a diuretic; in 

large doses depressant, causing nausea and vomiting, 
and lowering the rate of the heart, temperature, and 
respirations. It is used in asthma and whooping- 
cough. 

In cases of poisoning by Rhus toxicodendron, or 
poison ivy, it is said to be an excellent remedy, the 
fluid extract being applied locally. 

Dose of the fluid extract, tt[ v.- 3 i. (0.3-4 Cc.) 

Nat. Ord. Lobeliacecz. 
Lobelia (Indian Tobacco).. 

The leaves and tops of Lobelia inflata, of the United 
States. The active principle is called lobeline. 

Lobelia is a motor-depressant and anti-spas- 
modic. In small doses it stimulates the alimentary 
canal, and in full doses irritates it, causing pain, vomit- 
ing, purging, and general depression. 

L,arge doses cause, in addition, cold sweats, muscular 
tremors, feeble pulse, and stupor, with coma and col- 
lapse. It has frequently caused death, which occurs 
by paralysis of the respiratory centre. It is very 
seldom used, on account of its very depressing action. 

The treatment of poisoning consists in washing out 
the stomach with a warm solution of tannic acid (or 



THE VEGETABLE KINGDOM. 213 

warm, strong tea), the application of external heat, 
and stimulation by mustard, friction, etc.; and the use 
of alcoholic stimulants, ammonia, and opium. 

Preparations. 

Tinctura Lobeliae. 
Tincture of Lobelia. 

Strength, 10 #. Dose, % x.-xx. (0.65-1.3 Cc.) 

Fluidextractum Lobeliae. 
Fluidextract of Lobelia. 

Dose, TTl i.-v. (TTl i. = gtt. i.). (0.06-0.3 Cc) 

Nat Ord Styracacece. 
Benzoinum (Benzoin). 

The thickened juice of Sty rax benzoin, a tree ot 
Peru. It is soluble in alcohol; not readily soluble in 
water. Benzoin is a balsamic resin, containing from 
12 to 15 <f of benzoic acid. It is antiseptic and disin- 
fectant, and is said to have more power than salicylic 
acid to destroy bacteria and prevent putrefaction. 

Applied to the skin, it has a stimulating and heal- 
ing; action. Inhaled, or applied in solid form to the 
nose, it irritates the nasal and bronchial mucous mem- 
branes, but in proper solution acts on them only as a 
gentle stimulant. Taken internally it is diaphoretic, 
increases the urine and makes it more acid, and raises 
the pulse rate. It is excreted by the kidneys, partly 
as hippuric acid, and partly unchanged. 

Preparations. 

Acidum Benzoicum. 
Benzoic Acid. 

Dose, gr. v.-xx. (0.3-1.3 Gm.) 

Tinctura Benzoini. 
Tincture of Benzoin. 

Strength, 20$. Dose TTl, v.-xx. (0.3-1.3 Cc.) 



214 MATERIA MEDIC A FOR NURSES. 

Tinctura Benzoini Composita. 
Compound Tincture of Benzoin 
Friar's Balsam. 

For external use; it contains benzoin, aloes, styrax, 
balsam of tolu, and alcohol. 

Ammonii \ 

Lithii >• Benzoas. 

Sodii ) 

( Ammonium. 
Benzoate of -J Lithium. 

( Sodium. 

Dose, gr. v.-xxx. (0.3.-2 Gm.) 

Nat. Ord. Oleacea. 
Oleum Olivae (Olive Oil). 

The oil expressed from the fruit of Olea europ<za. 
Olive oil is composed of a fluid oil, olein; a solid oil, 
palmitin; with oleic and palmitic acids. 

Used externally by inunction, it is absorbed by the 
lymphatics, and has some nutritive value. 

As a mechanical application it is used both exter- 
nally and internally in the treatment of burns and 
corrosive poisons. It acts as a laxative, and is used 
for this purpose in enemata, tending to soften the faecal 
mass and assist in its expulsion. Oils in general are 
changed into carbonic acid and water in the system, 
and so excreted, but an excess will appear unchanged 
in the urine. 

Nat. Ord. Loganiacece. 

Spigelia (Pink-Root). 

Spigelia is an anthelmintic and purgative, and acts on 
the round worm. 

Fluidextractum Spigeliae. 
Fluidextract of Spigelia. 
Dose, TTj, x.-3 ii. (0.65-8 Cc.) 



THE VEGETABLE KINGDOM. 215 

Gelsemium (Yellow Jessamine). 

The root of Gelsemium sempervirens, of the Southern 
United States. The alkaloid gelsemium and gelse- 
minic acid are the important constituents. 

Physiological Actions. 

Gelsemium is a motor depressant and antispas- 
modic, acting by direct influence on the spinal cord. 
In medicinal doses it is sedative and diaphoretic. 

The smallest active quantity (TT[ v.-xv.) causes a 
languid feeling, with slight reduction of the strength 
and frequency of the pulse. If the amount be in- 
creased, pain over the eyes, some disturbance of vision, 
and dizziness result, with increased perspiration. It 
has a peculiar nervous effect on some people, making 
them cry without knowing why. 

Gelsemium relieves obscure pains and is used in a 
great many quack-cures for rheumatism, which are 
especially dangerous because of this drug and the 
ignorance of the laity in regard to it. 

Symptoms of Poisoning. 

Poisonous doses (3 i. of the fluidextract) produce, 
in addition to these symptoms, great muscular weak- 
ness, affecting especially the flexors of the arms. 

The gait also is affected, and becomes staggering. 
The jaw drops, and articulation fails. There is marked 
effect on the sight: double vision, partial or complete 
blindness may develop; sometimes a squint is pro- 
duced; the eyelid droops; the pupil dilates. 

There is profuse perspiration, cold surface and sub- 
normal temperature, and a condition of general anaes- 
thesia. The pulse is thready and feeble, and death 
finally results from paralysis of the respiratory muscles. 
Consciousness remains until carbonic - acid narcosis 
begins as the result of asphyxia. 

Gelsemium is rapidly diffused, and the effects appear 
within half an hour, and, after medicinal doses, dis- 
appear within two or three hours. 



2l6 MATERIA MEDIC A FOR NURSES. 

Death, when it occurs, may do so in a few hours, 
and has been known to result from taking one sixth of 
a grain. 

Treatment of Poisoning. 

Poisonous symptoms are treated by emetics, alcoholic 
stimulants, external heat, electricity, and artificial 
respiration, if necessary. 

Preparations. 

Fluidextractum Gelsemii. 
Fluidextract of Gelsemium. 

Dose, Til i.-v. (fTt x. = gtt. xxv.). (0.06-0.3 Cc.) 

Tinctura Gelsemii. 
Tincture of Gelsemium. 

Strength 10 $. Dose, 1T[ v.-xv. (0.3-1. Cc.) 
Nux Vomica (Poison Nut ; Quaker Buttons). 

The seeds of Strychnos nux-vomica, an East Indian 
tree. The active principle is the alkaloid, strychnine, 
an important poison. Two other important principles 
are brucine and igasuric acid. Brucine is of half the 
strength of strychnine. 

Physiological Actions. 

Nux vomica in medicinal doses is tonic, with the 
qualities of bitter stomachics ; it increases appetite, 
aids digestion, and promotes peristalsis. It also stim- 
ulates respiration, the heart, and vaso-motor centres. 
These actions are largely due to the presence and in- 
fluence of strychnine. Strychnine enters the system 
rapidly, especially the nervous tissues, on which its 
pre-eminent action, that of a motor excitant, is 
shown. It is excreted very slowly, not disappearing 
from the tissues for several days, and therefore accumu- 
lates in the system when given in continuous doses, 
even small ones. 

The power of strychnine in regard to the nervous 



THE VEGETABLE KINGDOM. 217 

system is exerted on the motor centres of the spinal 
cord and all the important nerve centres in the 
medulla. 

The first constitutional symptoms are a feeling of 
restlessness, with slight trembling of the extremities. 

After a full dose (gr. yV), there are noticeable mus- 
cular twitching and jerking of the limbs, slight stiff- 
ness of the jaw, a tense feeling about the head, stricture 
of the throat and chest, shuddering, and a feeling of 
anxiety. 

Symptoms of Poisoning. 

After poisonous doses (gr. \ for an adult), violent 
symptoms come on very suddenly, probably within 
fifteen minutes, with tonic convulsions resembling the 
spasm of tetanus. The legs are rigid, extended, and 
the feet averted, or the body may be bent backward 
until the head and heels meet (opisthotonos). The 
arms are bent, and hands clinched; the eyes open and 
staring. The corners of the mouth are drawn up by 
the muscles in a mechanical grin, the "risus sar- 
donicus," which gives a ghastly unmeaning expression, 
and the face— at first pale — presently becomes livid 
from asphyxia. 

Between the paroxysms there is a period of relaxation 
and quiet, but the slightest sound, or touch, or breath 
of air brings on the spasms again instantly by reflex 
action, owing to the condition of intense irritability. 

In cases which terminate fatally, the spasms succeed 
each other quickly, and death takes place in two or 
three hours from paralysis of the respiratory muscles. 
The mind usually remains clear up to the last. Some- 
times asphyxia produces insensibility just before death. 

Strychnine convulsions resemble tetanic and hys- 
terical convulsions in some particulars. The special 
points of difference are as follows: 

Strychnine. 

The convulsions begin with a restless, excited state; 
the special senses are sharpened. Muscular symptoms 



2l8 MATERIA MEDICA FOR NURSES. 

come on very rapidly, either beginning in the ex- 
tremities or appearing simultaneously over the body. 
The jaw is the last part affected and the first relaxed. 
The eyes are open, and the muscles are relaxed 
between the convulsions. 

Tetanus. 

The symptoms come on gradually, with pain and 
stiffness of the back of the neck and occasional slight 
muscular twitchings. The jaw is the first part 
affected, and is rigid (trismus, or lock-jaw). There 
is a permanent state of general muscular rigidity. 

Hysteria. 

Begins with weakness and blindness. The muscular 
symptoms begin with stiffness of the neck. The 
extremities are affected last. The jaw is set before a 
convulsion and remains fixed between them. The 
eyes are closed. 

Treatment of Poisoning. 

In treating strychnine poisoning, tannic acid or a 
soluble iodine salt is given as an antidote, followed 
quickly by emetics, as the compounds thus formed 
are not permanent. The bladder must be emptied to 
prevent re-absorption; then absolute quiet is of the 
greatest importance. Inhalations of chloroform are 
used, with full doses of chloral and bromide of potas- 
sium given internally. 

Precautions. 

In giving strychnine, the possibility of its cumula- 
tive action must always be kept in mind as a grave 
feature. It is more likely to develop if the medicine 
is in pill form than if in solution. With the liquid 
preparation of iron, strychnine, and quinine, the danger 
exists also as the strychnine is apt to precipitate. It 
must always therefore be well shaken. Strychnine 
is more effective with old people. 



THE VEGETABLE KINGDOM. 2 1 9 

The first constitutional symptoms are to be looked 
for with care: twitching, trembling, starting, or stiff- 
ness of the muscles. It is of great importance to 
know exactly when they begin, especially when, as is 
often the case, the orders received are to push the 
medicine to the utmost limit. 

Preparations of Nux Vomica. 

Extractum Nucis Vomicae. 
Extract of Nux Vomica. 

Dose, gr. J-i. (0.015-0.06 Gm.) 
Tinctura Nucis Vomicae. 
Tincture of Nux Vomica. 

Strength, 20 per cent. Five minims of the tincture 
represent ^o grain of strychnine. 

Dose, TTt v.-xx. (Til x. = gtt. xxv.). (0.3-1.3 Cc.) 

Fluidextractum Nucis Vomicae. 
Fluidextract of Nux Vomica. 

Dose, Til ■§— i. (Tii 3&. = gtt. xxv.). (0.03-0.06 Cc.) 

Extractum Nucis Vomicae, in pill. 
Extract of Nux Vomica. 

Dose, gr. \-\. (0.015-0.03 Gm.) 
All preparations of nux vomica are given before 
meals. 

Preparations of Strychnine. 

Strychninae Sulphas. 
Strychnine Sulphate. 

Dose, gr. Vo-2 1 o( Tr l x - = g tt: - x (0.001-0.003 Gm.) 

Ferri et Strychninae Citras. 
Iron and Strychnine Citrate. 
Dose, gr. i.-iii. (0.06-2 Gm.) 

Syrupus Ferri, Quininae, et Strychninae Phosphatum. 
Syrup of the Phosphate of Iron, Quinine, and Strychnine. 

One part strychnine to 2500. Dose, 3 i.-ii. (4-8 
Cc.) 



220 MATERIA MEDIC A FOR NURSES. 

Nat. Ord. Geiitianacecz. 

Gentiana (Gentian). 

The root of Gentiana lutea, the yellow gentian of 
the Alps, furnishes an efficient simple bitter and 
stomachic tonic. 

Preparations. 

Tinctura Gentianae Composita. 
Compound Tincture of Gentian. 

Strength 10 $. Dose, 3 i.-3 iv. (4-16 Gm.) 

Extractum Gentianae Fluidum. 
Fluidextract of Gentian. 

Dose, tt[. x.-xxx. (0.65-2 Cc.) 

Mistura Gentianae Alkalina. 
Alkaline Mixture of Gentian. 

Contains soda bicarb., dilute hydrocyanic acid, and 
gentian. 

Nat. Ord. Convolvulacece. 

Scammonium (Scammony). 

The root of Convolvulus scammonia yields an 
exudate from which is obtained a resin, having pro- 
perties as a drastic purgative. The chief ingredient 
of the resin is called jalapin, and is probably the same 
as the convolvulin of jalap. 

The dose of the resin of scammony is gr. ii.-x. 
(0.13-0.65 Gm.) 

Jalapa (Jalap). 

Obtained from the tuber of Ipom<za jalapa, a vine 
growing in Mexico. The active principle is a double 
resin, or one separable into two, called jalapin and 
convolvulin, the latter being the most important. Jalap 
is a hydragogue cathartic, and creates a feeling of 
nausea. In overdoses it causes severe vomiting and 



THE VEGETABLE KINGDOM. 221 

purging. The stools produced by its action are large 
and watery. It is seldom used alone, but is often 
combined with calomel. 

The compound powder, Pulvis Jalapae Compositus, 
contains jalap and cream of tartar. 

Nat. Ord. Apocynacecz. 
Strophanthus (Arrow-Poison). 

The seeds of Strophanthus hispidus, of Africa. The 
active principle is a glucoside named strophanthin. It 
exists in the seeds in a strength of 8 or 10 $. 

Physiological Actions. 

Strophanthus enters the blood and acts directly on 
muscular tissue as a tonic, increasing its contractile 
power, and, in poisonous doses, paralyzing and leav- 
ing it in a state of tetanic-like spasm, — not through the 
agency of the nervous mechanism, but by direct in- 
fluence on the muscle itself. This tonic and stimulant 
action is quickly felt by the heart, receiving as it does 
in a short time all the blood of the body, and thus feel- 
ing the action of the whole amount of strophanthus 
contained in it. The beats become less frequent and 
the cardiac contractions strengthened. 

Strophanthus resembles digitalis in its action on the 
heart, but it is not as lasting a stimulant, though act- 
ing more quickly. It differs from it also in not affect- 
ing the vaso-motor nerves. It is not irritating to the 
alimentary canal, and is not cumulative. It acts as a 
diuretic by increasing the supply of blood to the 
kidneys. 

Preparations. 

Tinctura Strophanthi. 
Tincture of Strophanthus. 

Dose, TT], v.-x. (TTl x. =± gtt. xx.). (0.3-0.6 Cc.) 

Strophanthin, for hypodermic use. 

Dose, gr. *-(&--&• (0.0003-0.001 Gm.) 



222 MATERIA MEDIC A FOR NURSES. 

Nat. Ord. Solanacece. 

Belladonnas Folia ; Belladonnas Radix. 
Deadly Nightshade. 

The leaves and root of Atropa belladonna, a per- 
ennial plant, native of Great Britain, and cultivated in 
this country. Belladonna contains two alkaloids: bel- 
ladonine, of no special importance; and atropine, the 
active principle, to which the medicinal and poisonous 
properties of the drug are owing. 

Physiological Actions. 

Alone or in a watery solution belladonna (or atro- 
pine) is not absorbed by the skin, but when combined 
with alcohol, glycerin, or camphor, it is readily so 
absorbed, and even more quickly by mucous mem- 
branes and inflamed surfaces; so that physiological 
symptoms, from the first slight dryness of the throat to 
evidence of severe poisoning, may be produced by 
external applications. 

Used in this way, belladonna acts upon the ends of 
the sensory nerves as an anaesthetic, relieving pain, 
as is seen in the action of belladonna plasters. This 
sedative power, exerted oyer the nerves which control 
the sweat glands, produces the familiar effect of drying 
up the secretion of milk and checking the action of the 
skin. 

Taken internally, belladonna enters the blood and 
reaches the tissues with rapidity; and in the case of 
atropine alone absorption is even more quickly accom- 
plished. Elimination takes place by the urine, and 
quickly, atropine appearing unchanged in from ten to 
twenty hours. 

The stimulant and tonic powers of belladonna, 
which are very strong, are exerted over the whole 
sympathetic system and unstriped or involuntary 
muscular fibre; and its sedative, anodyne actions 
are directed toward the motor system. It is a mydri- 



THE VEGETABLE KINGDOM. 223 

atic, dilating the pupils; an anti-spasmodic, and 
the most important respiratory stimulant known, 
keeping up the activity of the respiratory centre while 
at the same time allaying the irritability of the respira- 
tory nerves. 

It has but little control over severe pain, and is not, 
strictly speaking, an hypnotic, though it sometimes 
acts as one indirectly by removing conditions which 
prevented sleep. It has a peculiar effect on the brain, 
causing excitability, and in large doses narcotism. 

As a cardiac stimulant it weakens the force of the 
inhibitory apparatus, derived from the cerebro-spinal 
system, which retards the heart; and promotes the 
activity of the accelerator apparatus, derived from the 
sympathetic system, which excites the heart. 

The secretion of saliva is checked by belladonna, and 
this causes a dryness of the mouth and throat which 
is diagnostic and is watched for as one of the first 
signs of constitutional impression. 

When small doses of belladonna or atropine are given, 
the respirations become deeper and more frequent. 
The pulse, at first slowed for a short time, afterwards 
becomes strong and rapid, its rapidity being somewhat 
out of proportion to the rate of the respirations. 

After full doses it may rise as high as twice its 
former number of beats. The small vessels are more 
energetically contracted, and with the impetus to the 
circulation the temperature rises \° or i°. The pupils 
are dilated and vision disordered; the face flushed; the 
mouth and throat are dry; the tongue is red; swallow- 
ing is difficult, thirst is present, and a feeling as of sore 
throat. 

Symptoms of Poisoning. 

With larger doses the flush becomes a uniform bright 
red, and resembles the rash of scarlet-fever, except 
that it is not punctated. 1 It spreads first over face 

1 Having the appearance of being formed by exceedingly 
minute dots or points of red. 



224 MATERIA MEDIC A FOR NURSES. 

and neck, extending perhaps over the whole body, 
and is due to a reaction and paralysis of the vaso-motor 
nerves following the primary stimulation. 

The pupils are bright and widely staring. Headache 
and vertigo, restlessness, illusions, and delirium ap- 
pear. The delirium of belladonna is of a peculiarly 
active, talkative, busy type, accompanied frequently 
by laughter and gayety and associated with physical 
lassitude. The patient is sometimes absorbed with 
spectral illusions and visions, without showing any 
fear. Occasionally he becomes furious, quarrelsome, 
and maniacal. 

With larger poisonous doses there is loss of muscu- 
lar power, beginning in the lower extremities and 
becoming complete. Sensation is not lost. With ex- 
cessive poisonous doses convulsions may appear, and 
shortly before death stupor and paralysis develop, and 
the temperature becomes subnormal. The urine, at 
first increased, diminishes and may be entirely sup- 
pressed. Death results from asphyxia, from the failure 
of the respiratory organs, and there is heart failure as 
well. 

The smallest fatal dose is not positively known. 
Alarming symptoms have been produced by gr. -^o~tV 
of atropine, and death in fatal cases has occurred as 
early as five hours after taking the poison. 

Treatment of Poisoning. 

The first necessity is to use emetics or the stomach- 
pump. The bladder must be emptied at regular inter- 
vals to prevent re-absorption. Tannic acid is given; 
and external heat, mustard baths, hot and cold allu- 
sions to the head, and artificial respiration used. 

Incidental Effects. 

Medicinal doses sometimes produce mild delirium, 
or a feeling of thirst and feverishness. The local ap- 
plication of the drug to the eye sometimes causes an 
inflammation on the face about the eyelids. The rash 



THE VEGETABLE KINGDOM. 225 

of belladonna may appear after small doses, and may- 
desquamate; and a bluish color may be noticed on the 
lips. The dryness of the throat is always to be looked 
for. Children bear belladonna well. 

Preparations of Belladonna. 

Tinctura Belladonnae Foliorum. 
Tincture of Belladonna. 

From the leaves. Strength 1 in 6.66. Dose, TH, x.- 
xxx. (TTj, x = gtt. xxv.) (0.6-2 Cc.) 

Extractum Belladonnae Foliorum. 
Extract of Belladonna. 
Dose, gr. \-\. (0.008.-0.03 Gm.) 

Fluidextractum Belladonnas Radicis. 
Fluidextract of Belladonna Root. 
From the root. Dose, ttj, i.-ii. (0.06-0.13 Cc.) 

Emplastrum Belladonnae. 
Belladonna Plaster. 
Equals in strength its weight of belladonna root. 

Atropina. 
Atropine. 
Dose, gr. tJo - ^- (0.0004-0.001 Gm.) 

Atropinae Sulphas. 
Atropine Sulphate. 

Usually given hypodermically, being very soluble in 
water. Dose, gr. T Jq-gV (""l x = gtt. x.). (0.0005- 
0.0011 Gm.) 

Homatropinae Hydrobromidum. 
Homatropine Hydrobromide. 

This is a compound of atropine and oxytoluic acid in 
the form of a white crystalline powder resembling atro- 
pine in action, but being less toxic and the symptoms 
passing off more quickly. It is used as a mydriatic 
and anhydrotic. 

Dose internally, gr. ^j. (0.001 Gm.) 



220 MATERIA MEDICA FOR NURSES. 

Stramonium (Stramonium). 
Thorn Apple ; Jamestown Weed. 

The leaves and seeds of Daturia stramonium, a weed 
of this country and Great Britain. The active princi- 
ple is an alkaloid named daturine, which is said to be 
a combination of atropine and hyoscyamine. 

Physiological Actions. 

Stramonium resembles belladonna very closely in its 
actions. By small doses the pulse rate is increased, 
arterial tension raised, and the respiration quickened. 
It is a mydriatic, and has some power to relieve pain. 
One difference between them is that stramonium is 
more depressing to the bronchial nerves. 

The action on the intestinal muscular fibre is the 
same in both; small doses increasing, and large ones 
diminishing, peristalsis. By large doses the tension 
of the vessels is relaxed, the pulse still remaining 
frequent, and showing a tendency to intermit. 

Symptoms of Poisoning. 

The symptoms of poisoning are much alike — dilated 
pupils, heightened temperature, rapid pulse, scarlet 
rash, restlessness, delirium, and convulsions, with the 
fatal termination preceded by stupor, paralysis, and 
asphyxia. The pulse in stramonium poisoning is 
much more inclined to irregularity than in atropine 
poisoning. The treatment is the same. Accidental 
cases are common among children. 

Preparations of Stramonium. 

Extractum Stramonii. 
Extract of Stramonium. 

Dose, gr. J-J. (0.015-0.03 Gm.) 

Fluidextractum Stramonii. 
Fluidextract of Stramonium. 
Dose, Tit i.-ii. (0.06-0.13 Cc.) 



THE VEGETABLE KINGDOM. 22J 

Tinctura Stramonii, 
Tincture of Stramonium. 

Strength, 10 %. Dose, 1U x.-xx. (0.65-1.3 Cc.) 

Hyoscyamus (Henbane). 

The leaves of the second year's growth of Hyoscya- 
mus 7iiger y a coarse plant native in Great Britain and 
naturalized in the United States. The active princi- 
ples are two in number — hyoscyamine, a crystalline, 
and hyoscine, an amorphous, alkaloid. These princi- 
ples have the same chemical formula as atropine, yet 
are not identical with it. 

Physiological Actions. 

Hyoscyamus is a mydriatic, and has very much the 
same physiological actions as belladonna and stra- 
monium. It has greater calmative and hypnotic 
powers than either of the others, due, it is stated, to 
its hyoscine, which is supposed to be much stronger 
than hyoscyamine, and to have marked qualities as 
a cerebral sedative. 

Iyike the former two drugs, it is a cardiac and 
respiratory stimulant, the pulse under its influence 
being more regular than the pulse of daturine. It has 
the same stimulant action on the muscular fibres of the 
intestines, thus being somewhat laxative. In poison- 
ing, the dry mouth, flushed face, dilated pupils, and 
busy delirium are the same as with belladonna and 
stramonium, and the treatment is the same. Hyo- 
scyamine is rapidly excreted by the urine. 

Preparations of Hyoscyamus. 

Tinctura Hyoscyami. 
Tincture of Hyoscyamus. 

Made in a strength of 10 <$>. Dose, tt[ x.-xx. 
(0.65-1.3 Cc.) 



228 MATERIA MEDICA FOR NURSES. 

Fluidextractum Hyoscyami. 
Fluidextract of Hyoscyamus. 

Dose, ill i.-iii. (0.06-0.2 Cc.) 

Hyoscyaminae Sulphas. 
Hyoscyamine Sulphate. 

Dose, gr. -fa-i. (0.0016-0.06 Gm.) 

Hyoscinae Hydrobromidum. 
Hyoscine Hydrobromide. 

Hyoscine is a powerful hypnotic, and differs from 
atropine in reducing the pulse rate. This is the first 
evidence of its action, and is shown in a few moments. 
The fall may be from 8 to 20 beats in a moment, and 
this effect is the last to disappear. Hyoscine does not 
always dilate the pupils. It is eliminated by the urine. 

Dose, gr. t&tt" 5*0- (0.006-0.001 Gm.) 

Capsicum (Cayenne Pepper). 

The fruit of Capsicum fastigiatum, the African pep- 
per. The active principle is a very acrid oleoresin 
which is powerfully irritant, being capable of destroy- 
ing the skin if applied to it. Capsicum is a stimulant 
stomachic, giving, in moderate doses, a pleasant feel- 
ing of warmth. In overdose it may cause severe pain 
and inflammation, with vomiting and purging. "It is 
useful as a corrective in flatulence and slight diarrhoea. 

Preparations. 

Tinctura Capsici. 
Tincture of Capsicum. 

Strength, 10 <? . Dose, th, x.-xxx. (0.65-2 Cc.) 

Emplastrum Capsici. 
Capsicum Plaster. 






THE VEGETABLE KINGDOM. 22$ 

Tabacum (Tobacco). 

The leaves of Nicotiana tabacum, a native of tropi- 
cal countries cultivated in the North. 

They contain an exceedingly powerful alkaloid, 
nicotine; a volatile oil, nicotiana; and, in slight propor- 
tions, the following alkaloids, some of which are 
familiar as being found in other plants: lupuline, 
coniine, lobeline, piperidine, muscarine, and sparteine; 
also the alkaloidal compound trimethyamine. 

Tobacco smoke contains but little nicotine, if any, 
and a large proportion of pyridine. 

Nicotine is one of the most violent poisons known, 
acting almost as rapidly as prussic acid. 

Death has followed a toxic dose in three minutes. 
Emetics, tannin, and artificial respiration are to be 
employed in treating the poisoning. Tobacco is no 
longer used in medicine, being seriously depressing in 
its effects. 

Nat. Ord. Scrophulariacece \ 

Digitalis (Purple Foxglove). 

The leaves of the second year's growth of Digitalis 
purpurea, native of Great Britain, and cultivated in 
this country. 

The active principle, digitaline, occurs in two forms, 
one amorphous and the other crystalline, and is com- 
posed of four glucosides. Digitaline is no longer official, 
the preparations made from the whole leaf being con- 
sidered more trustworthy. 

Physiological Actions. 

The most important action of digitalis is as a heart 
stimulant and tonic, and is shown in the slowing and 
strengthening of the pulse. This is partly brought 
about by a direct action on the heart-muscle, by which 
the circulation in the organ itself is more efficiently 
carried on; partly by a strengthening of the inhibitory 



23O MATERIA ME DIC A FOR NURSES. 

apparatus, which tends to slow the heart; and partly 
by a stimulant action on the vaso-motor system, by 
which the arteries are more strongly contracted, and, 
by offering some resistance to the force of the heart, 
excite it to greater effort. The result of all this is, that 
the diastole is lengthened, and the systole becomes 
more energetic. Thus the ventricles are better filled 
and more thoroughly emptied, and the beats, reduced 
in number, gain in firmness and strength. 

When an excessible amount is taken, signs of over- 
stimulation appear, marked by intermittency of the 
pulse or by a fall below normal; it may be to 40 or 50 
in a minute. In this condition any sudden exertion, 
such as sitting upright, may bring to a climax the 
growing exhaustion of the heart, and the pulse may 
run up to 150 or more, becoming small, weak, and 
irregular. For this reason patients taking digitalis 
continuously must be kept quietly in bed and not 
allowed to sit up or to make any sudden exertion. 

In taking it only occasionally or for a short time 
there is not the same danger. 

Digitalis is also a diuretic, acting through an in- 
fluence on the renal as well as on the general circula- 
tion, and for this purpose it is also used locally in the 
form of poultices applied over the kidneys, and made 
from the leaves or with the fluid preparations. Digi- 
talis is eliminated by the urine, and much more slowly 
than it is absorbed into the system. For this reason, 
if doses are given close together, part of the influence 
of one may be added to that of the next, and the action 
is intensified by so much. But except conditionally 
in this way, a cumulative action of the drug is not 
acknowledged by all authorities. 

Symptoms of Poisoning. 

In cases of poisoning the symptoms begin with vio- 
lent and repeated vomiting of mucus and bile. There 
is a feeling of vertigo, pain, and heat in the head, and 
disturbance of vision, fringes of color with a vibratory 
motion being sometimes seen around objects. 



THE VEGETABLE KINGDOM. 23 1 

The face is pale, the eyes staring and prominent, 
with dilated pupils and a blue color of the sclerotics. 

There is sometimes salivation, and usually diarrhoea. 
The urine may be suppressed. The vomiting con- 
tinues, and great prostration follows. The pulse is 
irregular, small, and weak, yet the beat of the heart 
may be hard and strong. The respirations become 
rapid and feeble. Pains in the limbs and back may 
be present. There are, usually before the end, de- 
lirium and stupor, or convulsions. Death occurs from 
general failure of the circulation with final paralysis 
of the heart, and has taken place as soon as three 
quarters of an hour after taking the poison. The 
average time, however, is one or two days. Digitalis 
poisoning of an acute form is not common, and in the 
majority of cases the patient recovers. The smallest 
fatal dose is not known. Twenty grains of the extract 
are known to have caused death in ten days. 

Treatment of Poiso?iing. 

Emetics and cathartics must be given, and tannin in 
large quantities. Alcoholic stimulants are used, but 
with great care, and the most perfect rest and quiet, 
with a perfectly horizontal position, maintained. 

Incidental Effects. 

Digitalis is very bitter, nauseating, and irritant to 
the stomach, and is apt to interfere with digestion, and 
to cause vomiting, with occasional diarrhoea, marked 
by green discharges. These two latter symptoms may 
also be produced by hypodermic administration of the 
drug. 

Headache and vertigo, fainting, sneezing, and buz- 
zing in the ears, are caused by overdoses; also sparks 
before the eyes and other disturbances of sight; sleep- 
lessness; fall of temperature; and irregularity or 
threadiness of the pulse. 

Recent experiments prove that digitalis does not in- 
crease the strength or force of the heart's beats, but 



232 MATERIA MEDIC A FOR NURSES. 



simply the extent of the contraction is increased. The 
heart cavity is more nearly closed and the contrac- 
tion of the heart- muscle is more nearly complete than 

is normally the case. This 
schema represents that ac- 
tion : The contraction is pro- 
longed, hence the heart is 
slowed and more blood is 



IDJDI 



forced into the circulation with each beat. Digitalis 
is to be used in all heart lesions with broken compen- 
sation. It should be given in a course of twelve 
doses, one dose every four hours. Then wait a day 
or two and repeat if necessary. Hypodermic injec- 
tions of digitalis or of strychnine act in case of shock 
by a redistribution of the blood in different parts 
of the body, thus restoring function. Digitaline ma}' 
be used in cases where digitalis cannot be taken by 
mouth. Dose, -fa— fa gr. American digitaline, or T 1 ^- 
\ gr. Merck's German digitaline, injected deep into the 
muscles of the thigh, which are then to be rubbed 
thoroughly for at least five minutes to hasten absorp- 
tion and prevent abscess formation. 

Preparations of Digitalis. 

Infusum Digitalis. 
Infusion of Digitalis. 

Strength, i to 66.6. Dose, 3 i.- ? ss. (4-16 Cc.) 
More diuretic than stimulant. To be largely diluted. 

Tinctura Digitalis. 
Tincture of Digitalis. 

Strength, 10 #. Dose, tt[ v.-xx. (0.3-1.3 Cc.) 

Fluidextractum Digitalis. 
Fluidextract of Digitalis. 

Dose, tt[ i.-ii. (7T[ i. = gtt. ii.). (0.06-0.13 Cc.) The 
tincture and fluidextract are more stimulant than 
diuretic, and are only slightly diluted when given. 



THE VEGETABLE KINGDOM. 233 

Digitaline. 

Dose, gr. -g^. (0.0013 Gm.) It has been used hypo- 
dermically, but is irritating and much more liable to 
cause abscesses than either the tincture or the fluid- 
extract given in the same way. 

Nat. Ord. Labiates. 

Oleum Lavandulae Florum (Oil of Lavender 
Flowers). 

An oil obtained from the flowers of Lavandula 
qfficifialis. 

Tinctura Lavandulae Composita. 
Compound Tincture of Lavender. 

May be pleasantly used, in small quantity, added to 
water for bathing. 

Spiritus Lavandulae. 
Spirits of Lavender. 

A stomachic and cordial. Dose, 3 ss.-ii. (2-8 
Cc.) 

Oleum Menthae Piperita^ (Oil of Peppermint). 

The oil of the fresh flowering peppermint. 

Aqua Menthae Piperitae. 

Used as a carminative. Dose, 3 iv.- vi. in water. 
(16-24 Cc.) 

Menthol. 
Peppermint Camphor. 

A stearoptene obtained from peppermint oil. Used 
as a local anaesthetic in headache, in the form of a 
pencil. 

As a specific in consumption injected into the larynx 
(12 io solution in olive oil), or as a carminative in epi- 
gastric pain, taken internally. 



234 MATERIA MEDIC A FOR NURSES. 

Thymol. 

A stearoptene from the volatile oils of Thymus 
vulgaris and other herbs. It is an antiseptic and 
germicide resembling carbolic acid and oil of tur- 
pentine in action. Used as a specific in certain forms 
of intestinal parasites (uncinaria, etc.). 

Nat. Ord. Polygonacece. 
Rheum (Rhubarb). 

The root of Rheum officinale, from China. 

Rhubarb contains cathartic acid, a peculiar tannic 
acid, a yellow coloring matter, etc. 

Rhubarb acts entirely on the alimentary canal. In 
small doses it is stomachic, strengthening appetite 
and digestion. In large doses it is a cathartic, with 
astringent after-effects. 

In its purgative action the liver is stimulated as well 
as the intestinal glands, and evacuation takes place in 
six or eight hours, accompanied by some griping pain. 

Preparations of Rhubarb. 

Fluidextractum Rhei. 
Fluidextract of Rhubarb. 
Dose, TT[ xv.-xxx. (TTj, x. = gtt. xx.). (1-2 Cc.) 

Syrupus Rhei. 
Syrup of Rhubarb. 
Dose, for infants, 3 i. (4 Cc.) 

Tinctura Rhei. 
Tincture of Rhubarb. 

Dose, 3 i.-ii. (4-8 Cc.) 

Nat. Ord. Lauracece. 

Camphora (Camphor). 

A stearoptene obtained from the wood of China- 
momum camphora, of China and other Eastern 
countries. 



THE VEGETABLE KINGDOM. 235 

Camphor is one of the most widely diffused of all 
vegetable substances. It is found in pennyroyal, 
hemp-tops, and numbers of other plants. 

Physiological Actions. 

Externally applied, camphor is irritant, stimulat- 
ing the local circulation. It has feeble antiseptic 
power, and is sedative to the nerves after first stimu- 
lating them. Internally, it acts as a carminative and 
anti-spasmodic, gives increased force and fulness to 
the pulse, and stimulates the cerebro-spinal nerves. 
When large doses (gr. xx.-xxx.) are given, the pulse 
falls, and a feeling of lassitude and giddiness is 
produced. 

Symptoms of Poisoning. 

After poisonous doses (gr. xxx.-lx.), there are faint- 
ness and headache, vertigo, confused ideas, burning 
pain in the stomach, delirium, convulsions, and in- 
sensibility. The pulse is small, sometimes slow, again 
accelerated. The skin is pale, cold, and covered with 
perspiration. No death of an adult has occurred with 
camphor. 

Preparations. 

Aqua Camphorae. 
Camphor Water. 

Strength, 1 to 125. Dose, 3 ii.-iv. (8-16 Cc.) 
Spiritus Camphorae. 
Spirits of Camphor. 

Strength, 1 to 10. Dose, ttx, v.-xx. (0.3-1.3 Cc.) 

Linimentum Camphorae. 
Camphor Liniment. 

Cotton-seed oil, 8 parts; camphor, 2 parts. 
Linimentum Saponis. 
Soap Liniment. 

Soap, 6 parts; camphor, 5; alcohol, 70; oil of rose- 
mary and water to 100 parts. 



236 MATERIA ME DIC A FOR NURSES. 

Oleum Camphorse. 
Oil of Camphor. 

More stimulating than the other preparations. 
Dose, i\[ v.-x. (1U x. = gtt. xx.). (0.3-0.65 Cc.) 

Cinnamomum (Cinnamon). 

The bark of different varieties of the genus Cinna- 
mon. It contains tannic acid and a yellowish volatile 
oil, oleum cinnamomi. This has a fragrant and pleas- 
ant taste, and is used to mitigate that of disagreeable 
drugs. The preparations of cinnamon are used as 
carminatives. 

Pulvis Aromaticus. 
Aromatic Powder. 

Is composed of cinnamon, ginger, cardamom, and 
nutmeg. It is given in doses of gr. x-xx. (0.65-1.3 
Gm.) 

Nat. Ord. Aristolochice. 

Serpentaria (Snakeroot). 

The dried rhizome and rootlets of two or three 
varieties of Aristolochise, found in North America. 
The taste and odor resemble camphor. It contains a 
resin, a volatile oil, bitter principle, etc., and is a 
stimulant tonic. 

Preparations. 

Tinctura Serpentariae. 
Tincture of Snakeroot. 

Strength, 20 $. Dose, 3 i- — ii- (4-8 Cc.) 

Extractum Serpentariae Fluidum. 
Fluidextract of Snakeroot. 

Dose, m xx. (1.3 Cc.) 

To be given half an hour before meals. 



THE VEGETABLE KINGDOM. 237 

Coto Bark. 

The bark of trees found in South America, some- 
what similar to the Cinchona, having an aromatic 
resinous odor and pungent taste. It contains a bitter 
principle, cotoin, and has astringent action. It is 
irritant to the skin and mucous membranes. 

Fluidextractum Coto. 
Fluidextract of Coto Bark. 

Dose, TTt i.-xv. (TTt x. = gtt. xx.) (0.06-1. Cc.) 
Should be given in wine or other dilute alcohol, as 
it does not combine with water, but forms a precipitate. 

Cotoin. 
Coto Bark. 
Dose, gr. \-\\. (0.03-0.13 Gm.) 

Nat. Ord. Euphorbiacea. 

Oleum Tiglii (Croton Oil). 

A fixed oil, obtained from the seeds of Croton 
tiglium, a shrub of Asia. The oil is quite thick and 
becomes more so with age; deteriorates rapidly in 
quality and should not be kept long, but, if possible, 
always obtained fresh. In color it may vary from a 
pale yellow to a dark reddish-brown. The taste is 
acid and hot. 

It is a very complex substance, containing several 
fixed oils and volatile acids. It is supposed to con- 
tain a vesicating principle and a distinctly purgative 
one, but the latter has not yet been obtained separate 
from the others. Croton oil is soluble in alcohol. 

Physiological Actions. 

It is a very powerful irritant and vesicant when 
externally applied, causing burning and redness of the 
skin and an eruption of papules, which in a short time 
become pustular. Taken internally it irritates actively; 



238 MATERIA ME DIC A FOR NURSES. 

causes burning in the throat and epigastrium, and 
has a very rapid action as a drastic and hydragogue 
cathartic. 

The bowels are first opened in one or two hours after 
it is taken, and catharsis re-occurs several times within 
twelve hours or more, with great thoroughness, some 
pain, and, usually, a decided degree of prostration. 

The dose, which is usually one or two drops— some- 
times three or four— may be given on bread-crumbs, or 
in a little glycerin, or on a lump of sugar. 

With unconscious or delirious patients it may be 
placed directly on the back of the tongue. In apply- 
ing it externally, the amount ordered is taken on a 
bit of flannel, and rubbed into the prescribed spot on 
the skin until there is well-marked redness. The 
eruption appears usually in about four hours; if it does 
not, the application is repeated. 

It may also be mixed with olive oil or turpentine, or 
combined with liniments, alcohol, or ether. 

The eruption remains for several days, and may, on 
disappearing, leave small cicatrices behind it. 

Symptoms of Poisoning. 

Though so active in small doses there have not been 
many known instances of fatal poisoning by croton oil. 
Large doses usually provoke immediate vomiting, but 
symptoms when developed are those of gastro-enteritis, 
with violent catharsis and great prostration. 

In some instances, instead of acting in the usual way 
it seems to be absorbed into the blood, and produces 
nervous symptoms, such as palpitation and restless- 
ness, headache, giddiness, and confusion of ideas. 

Oleum Ricini (Castor Oil). 

The oil expressed from the seeds of Ricinus com- 
munis^ of Calcutta. Castor oil contains several fatty 
acids, of which riciuoleic acid is peculiar to itself. 






THE VEGETABLE KINGDOM. 239 

Physiological Actions. 

Externally castor oil is very soothing, and may be 
applied to the eye, or the surface, as a sedative and 
protective. 

Internally it is unirritating to the stomach, if pure, 
but if impure or rancid it may cause nausea and vomit- 
ing. Aside from this, the odor may provoke nausea 
even before the drug is swallowed, and all pains should 
be taken to avoid this possibility, by preparing it care- 
fully and holding it at the side — not under the patient's 
nose — until the moment comes for swallowing it. 

In the intestines it acts as a simple purgative, and 
here the oil which is not perfectly pure is more efficient. 
It is painless, with sedative and somewhat constipating 
after- effects. 

The muscular coat and the glands of the intestines 
are stimulated, and evacuation results in from three to 
six hours — sometimes sooner. 

It is not a hydragogue cathartic, as it does not ap- 
preciably increase the intestinal secretions. It does 
not act on the liver. 

Ricinoleic acid enters the blood and tissues and is 
removed by all secretions, including the milk, and in 
this way purgation may be produced in a nursing 
infant. 

Castor oil is very nauseous, and needs to be carefully 
administered, in order that it may be as little offensive 
as possible. To children it is best given in hot sweet- 
ened milk, and adults may take it well in this way; or 
it may be poured into the centre of an equal quantity 
of glycerin, or given in a little hot coffee, or in soda 
water, or in brandy; first wetting the sides of the glass, 
and pouring the oil carefully in the centre of 3 ss. 
brandy, then covering it with as much more. In all 
cases it will be more easily taken if the mouth be first 
rinsed out with brandy or peppermint, or any thing 
pungent which will blunt the sense of taste. A little 
carbonated water afterwards is gratefully received, or, 
to those who like olives, nothing is more acceptable 



240 MATERIA MEDICA FOR NURSES. 

after nauseating or bitter medicines than an olive, 
when it may be given. 

Castor oil can be had put up in soft flexible capsules, 
which, though large, are easily swallowed. 

Dose, 1 ss.-i. (16-32 Cc.) 

Dose for infant one year old, 3 i.-ii. (4-8 Cc.) 

The castor bean is very poisonous. The leaves are 
used as a poultice, applied to the breasts to increase 
the flow of milk. 

Nat. Ord. Salicacecz. 

Salicinum (Salicin). 

A glucoside, obtained from the bark of various 
species of Salix or willow tree, and from Gaultheria 
procumbens or wintergreen. 

Salicin is a bitter tonic, and to some extent an 
antipyretic and antiseptic. Its qualities resemble, 
though in a very mild degree, those of salicylic acid, 
which is derived from it. Salicin is not poisonous. It 
is very insoluble, and is given dry on the tongue or in 
capsules. 

Dose, gr. xx. (1.3 Gm.) 

Oleum Gaultheriae (Oil of Gaultheria). 
Oil of Wintergreen. 

A volatile liquid of penetrating odor. It is composed 
of methyl salicylate, 90 $, and gaultherilene, a hydro- 
carbon, 10 <?o. In nature it is found in the wintergreen, 
Gaultheria procumbens, called the teaberry. Another 
natural oil almost, if not quite, identical with it, is the 
oil of sweet birch, oleum Betulce volatile, and it is also 
practically the same substance as the synthetically 
prepared methyl salicylate. The artificial oil is now 
largely used instead of the natural oil. 

The physiological actions of the oil of gaultheria are 
the same as those of salicylic acid. 

It is given in emulsion or capsules. 

Dose, TT[ v.-x. (0.3-0.65 Cc.) 



THE VEGETABLE KINGDOM. 241 

Nat. Ord. Zingiberacece. 
Zingiber (Ginger). 

The dried root- stock of Zingiber officinale of the East 
and West Indies. The active principles are an aromatic 
resin and a volatile oil. Ginger is a stimulant and 
carminative, and is given for colic or cramp. The 
tincture is used in doses of from 3 ss.-i. (2-4 Gm.), 
in hot water; the fluid extract, Tr[ v.-x. (0.3-0.65 Cc). 

Cardamomum (Cardamom). 

The fruit of Elettaria repens of the East Indies. The 
seeds contain a fixed and also a volatile aromatic oil. 

Cardamom is a pleasant stomachic, less heating 
and stimulating than others of its class. 

The tincture is given in doses of 3 i. (4 Gm.), and 
is also used as an ingredient in tonic mixtures. 

Cannabis Indica (Indian Hemp). 

Various forms of hemp are sold and used in the East 
as narcotic stimulants. The dried plant is sold in 
Calcutta for smoking, and is called Gunjah. Churrus 
is the resinous exudation with scrapings of the leaves, 
and Hashish is an Arabian preparation. The resin, 
which represents the active principle of hemp, is 
obtained by precipitating the saturated tincture with 
water containing an alkali. 

Physiological Actions. 

Cannabis indica in full doses causes a mental state of 
joyous exhilaration. The subject may fall into a 
revery, while beautiful visions pass before the eyes, or 
he may laugh loudly and give other manifestations of 
being in an ecstatic state. The pupils dilate and the 
pulse-rate rises. Partial anaesthesia, local spasms, and 
convulsions may be noticed. After the first stage the 
subject falls into a heavy sleep. The Hindoos are said 
to induce a state of catalepsy by the use of hemp. 



242 MATERIA MEDICA FOR NURSES. 

It is not an acute poison, and does not endanger life, 
even when the symptoms produced by it are of an 
alarming character. There are not the unpleasant 
after-effects of opium. The stomach is not affected, 
nor is there constipation. The urine, rather than 
decreasing, is increased by this drug. 

It has been used to some extent in the treatment of 
insanity, and, aside from that, for the relief of pain and 
as a hypnotic. Various quack medicines advertised as 
" pain killers " contain cannabis. 

The action of the different preparations is variable, 
and it is supposed that much of the supply loses its 
strength during the ocean voyage, and becomes inert. 

Preparations. 

Tinctura Cannabis Indies. 
Tincture of Cannabis Indica. 

Strength, 10 %. 

Fluidextractum Cannabis Indies. 
Fluidextract of Cannabis Indica. 

Dose, TT[ i.-xxx. (0.06-2 Cc.) 

Nat. Ord. Urticacece. 
Lupulus (Hops). 

The dried strobiles 1 ot Hamulus lupulus, or hop 
vine, cultivated in England. They contain an aromatic 
volatile oil, valerol; a bitter principle, lupulinic acid, 
etc. 

The former gives a stimulant action, with after- 
effects that are sedative and sleep-producing. The 
latter gives stomachic and tonic qualities. Hops are 
also slightly astringent. These various character- 
istics are shown in ales and beers, which are made 
from hops. The heart action is somewhat strengthened 
and quickened by hops, and diaphoresis produced. 

1 Cones; from the Latin word meaning a pine cone. 



THE VEGETABLE KINGDOM. 243 

Hops are used externally for the relief of pain, either 
as a means of applying moist heat, when they are put 
into bags and wrung out of hot water; or as dry heat 
when — also in bags — they are heated through. 

Lupulinum. 
Lupulin. 

Dose, gr. v.-xx. (0.3-1.3 Gm.) 

Fluidextractum Lupulini. 
Fluidextract of Lupulin. 

Dose, TT[ v.-xx. (0.3-1.3 Cc.) 

Hop pillows may be used as a means of inducing 
sleep. The crackling of the hops, which may annoy, 
may be stopped by sprinkling them with alcohol. 

Nat. Ord. Coniferce. 

Pix Liquida (Tar). 

Tar is an oleoresin obtained by the destructive dis- 
tillation of the wood of several varieties of pine. It 
contains pyroligneous acid, methylic alcohol, acetic 
acid, creosote, and several hydrocarbons, one of which 
is called toluene, also oil of tar, with other oily bodies, 
and pyrocatechin. 

The oil of tar, oleum picis liquidae, is used locally and 
by inhalation. It contains a large number of com- 
pounds, among which are creosote and carbolic acid. 

Tar ointment has 50 <f of tar. The syrup of tar has 
7! <f> of tar. 

Oleum Terebinthinae (Oil of Turpentine). 

The oil distilled from turpentine, which is obtained 
from several varieties of pines, chiefly those growing 
in the Southern United States. 

Turpentine, as such, is not used in medicine. It 
may be separated into the oil and a resin, which, com- 
bined with lead plaster, forms adhesive plaster, 



244 MATERIA MEDICA FOR NURSES. 

Physiological Actions. 

Externally oil of turpentine is stimulating and very 
irritant, causing redness and heat followed by vesica- 
tion. Its action as a counter-irritant needs to be 
watched with much care, as severe blistering, with 
depression of the general system, may result if its 
applications be too long continued. Turpentine is 
absorbed by the whole skin, and enters the blood 
unchanged. 

Internally in moderate doses its immediate action is 
slightly antiseptic and stimulant to the blood-vessels. 
On the nerves it acts locally as a sedative, and in the 
intestines stimulates the muscular coat, and is, in 
larger doses, a purgative. 

It is a carminative, expelling gas from the intes- 
tines, and this result is produced as well by outward 
applications and by enemata as when given by mouth. 
It is also an anthelmintic, and is given in enemata for 
thread-worm. 

It is a stimulant diuretic, producing in large doses 
active irritation or congestion of the urinary organs, 
with pain, or it may be strangury or hematuria. The 
strength and rapidity of the pulse are increased by 
turpentine. 

In large doses it has a sedative effect on the brain 
and spinal cord, shown by heaviness and drowsiness, 
an unsteady gait, and debility. The temperature is 
lowered slightly. It is eliminated by the kidneys and 
lungs, giving its own odor to the breath, and the odor 
of violets to the urine. 

Turpentine is capable of causing death, but fatal 
cases are very rare, and there are but few instances 
even of serious poisoning. 

Symptoms of Poisoning. 

The symptoms recorded in such cases include 
usually vomiting and purging, though they do not 
always exist. The pupils are dilated; the pulse rapid, 
weak, and irregular. The skin may be either dry or 



THE VEGETABLE KINGDOM. 245 

moist; the urine diminished or suppressed altogether, 
or containing blood. In most cases unconsciousness 
is complete. 

Death in one instance was supposed to have followed 
a dose of \ vi., but recovery has taken place in other 
cases after doses nearly as large. 

Oleum Terebinthinae Rectificatum. 
Rectified Oil of Turpentine. 

Dose, TTl x.-xx. (0.65-1.3 Cc.) 

It may be given on a lump of sugar. The oil and 
spirits of turpentine are the same, the only difference 
being that spirits have been redistilled. 

Sanitas. 

A disinfectant fluid, put up for use in sick-rooms. 
It is made with oxydized turpentine, and contains 
peroxide of hydrogen as active principle. It does not 
stain clothing. 

Oleum Juniperi (Oil of Juniper). 

The oil from the full-grown unripe fruit of Jtiniperus 
communis. 

Juniper resembles turpentine in many of its actions, 
but it is less powerful and also less disagreeable. It is 
a stomachic stimulant and diuretic. In large doses 
it inflames the kidneys and produces strangury. 

Dose, ttl v.-xv. (tt[ x. = gtt. xx.). (0.3-1 Cc.) 

Sabina (Savin). 

The dried tops of a juniper tree of the East. The 
active principle is a volatile oil which is highly stimu- 
lating when applied locally or given internally. Savin 
is an emmenagogue. In large doses it causes all 
the symptoms of poisoning of the gastro-intestinal 
irritants, and is capable of producing abortion. 

Preparations. 

Oleum Sabinae. 
Oil of Savin. 

Dose, ttl v.-x. (0.3-0.65 Cc.) 



246 MATERIA MEDICA FOR NURSES. 

Nat. Ord. Liliacece. 
Scilla (Squill ; Sea-Onion). 

The bulb of Urgi?iea maritima, a plant of Southern 
Europe. 

Squill increases the strength and reduces the fre- 
quency of the heart action; contracts the arterial 
system and raises blood pressure. It is diuretic by 
means of its action on the circulation in the kidneys, 
and a stimulant expectorant, increasing the bron- 
chial secretion by improving the local circulation and 
aiding in the expulsion of the mucus. 

In overdoses it is irritant, and may cause inflam- 
mation of the kidneys, with strangury and bloody 
urine, or suppression. It is also irritant to the stomach 
and intestines, and even in medicinal doses may dis- 
order digestion. Full doses cause nausea, vomiting, 
and diarrhoea. 

Symptoms of Poisoning. 

Fatal poisoning has been caused by squill, in which 
these symptoms were present in an aggravated form, 
with marked depression of the pulse, convulsions, and 
collapse. Death has resulted from a dose of 24 grains. 

Treatment of Poisoning. 

The stomach and bowels must be emptied by ipecac 
and castor oil. Large quantites of water should be 
given to overcome the suppression of urine, and the 
usual methods of treating gastro-enteritis and collapse 
employed. 

Preparations. 

Tinctura Sciilae. 
Tincture of Squill. 

Strength, 10$. Dose, Til x.-xx. (0.65-1.3 Cc.) 



THE VEGETABLE KINGDOM. 247 

Fluidextractum Scillae. 
Fluidextract of Squill. 

Dose, TT[ i.-iii. (tti i. = gtt. ii.). (0.06-0.2 Cc.) 

Syrupus Scillae. 
Syrup of Squill. 

Dose, 3 ss.-i. (2-4 Cc.) 

Syrupus Scillae Compositus. 
Compound Syrup of Squill. 

Contains squill, senega, and tartar emetic. Dose, 
TT[ x.-xxx. (tt[ x. = gtt. x.). (0.6-2 Cc.) 

Sarsaparilla (Sarsaparilla). 

The two varieties of Sarsaparilla used in medicine 
come from Honduras and Brazil, and are obtained 
from the root of Smilax officinalis and other varieties 
of smilax. The drug contains three glucosides : paril- 
lin, saponin, and sarsaponin. 

Sarsaparilla is widely used, yet no definite physio- 
logical actions can be claimed for it. Whatever value 
it may have is as an alterative. The syrup is some- 
times used to disguise the taste of potassium iodide. 

Preparations. 

Syrupus Sarsaparillae Compositus. 
Compound Syrup of Sarsaparilla. 

Contains sarsaparilla, liquorice root, senna, oil of 
sassafras, oil of anise, and oil of gaultheria. 
Dose, 3 ss.-i. (16-32 Cc.) 

Fluidextractum Sarsaparillae Compositum. 
Compound Fluidextract of Sarsaparilla. 

Contains sarsaparilla, liquorice root, sassafras, and 
mezereum. 

Dose, 3i. (4 Cc.) 



248 MATERIA MEDICA FOR NURSES. 

Aloe (Aloes). 
Barbadoes and Socotrine Aloes. 

The thickened juice of the leaves of Aloe socotrina, 
from an island in the Indian Ocean, and Arabia. It 
has a very nauseous and bitter taste, and contains an 
active principle, aloin, which has cathartic qualities. 

Aloes is a bitter stomachic, and as a cathartic acts 
principally on the colon, and with extreme slowness, 
ten or fifteen hours being required for a result if it is 
given alone. It stimulates the flow of bile to some 
extent, and excites the circulation of all the pelvic 
organs. Aloes is rarely used alone, but is an ingredi- 
ent of many well-known laxative preparations in 
liquid and in pill form, usually in strength of 2 or 3 
grains. It does not cause constipation as an after- 
effect, but, on the contrary, makes the intestines more 
sensitive. 

Tinctura Aloes. 
Tincture of Aloes. 

Strength, 10 ^. Dose, Til x.- 3 i. (0.7-4 Cc.) 

Tinctura Aloes et Myrrhae. 
Tincture of Aloes and Myrrh. 

Strength, 10$ of each. Dose 3 ss.-ii. (2-8 Cc.) 

Pilulae Aloes et Mastiches. 
Lady Webster's Dinner Pills. 

Each contains two grains of aloes. 

Nat. Ord. Labiates. 

Convallaria (Lily of the Valley). 

The entire plant of the Convallaria majalis, the lily 
of the valley. It contains two glucosides: one, con- 
vallarin, is crystalline, and has special qualities as a 
gastro-intestinal irritant; and the other, convallamarin, 
is amorphous, and acts as a stimulant to the circula- 
tion. 



THE VEGETABLE KINGDOM. 249 

Physiological Actions. 

Convallaria slows and strengthens the heart, and 
raises the blood pressure; makes the respirations a 
little more full and less frequent than ordinary, and is 
a very decided diuretic. In excessive doses the heart 
is disturbed and the pulse becomes irregular; the 
breathing is forced, deep and prolonged inspiration 
being produced by spasm of the inspiratory muscles. 

When a poisonous quantity is taken, arterial pres- 
sure rises very high, and the pulse is correspondingly 
rapid, until shortly before death, when the pressure 
falls, respiration grows slow and deep, and the heart 
stops in systole. Convallaria does not affect the brain. 

Preparations. 

Fluidextractum Convallariae. 
Fluidextract of Convallaria. 

Dose, TTj, ii.-x. (ff|, x, = gtt. xxv.). (0.1-0.65 Cc.) 

Convallarinum. 
Convallarin. 

Dose, gr. ss.-ii. (0.03-0.13 Gm.) 

Nat. Ord. Phytolaccacece. 
Phytolacca (Poke). 

The berry and root of Phytolacca decandra. Phy- 
tolacca is depressing to the heart and respirations, and 
is to some extent narcotic. It is an alterative, and 
promotes absorption of fatty tissue. "Anti-fat" 
remedies sometimes contain Phytolacca. It is useful 
as a local medicament, and is used in various skin 
disorders. 

The dose of the fluid extract is tt[ v.-xxx. (0.3-2 
Cc.) 



2$0 MATERIA MEDICA FOR NURSES. 

Nat. Ord. Melanthacece . 

Veratrum. (Indian Poke ; American Hellebore). 

The dried root-stock of Veratrum viride, a plant 
belonging to the Northern States of the United States. 
It yields two alkaloids, jervine and veratroidine. 

Physiological Actions. 

Veratrum viride is a powerful cardiac depressant. 
When taken in small doses the pulse is at first reduced 
in strength and later in frequency, being sometimes 
lowered to 35 or 40 a minute. The fall of the pulse is 
in constant proportion to dose taken. It is then soft, 
compressible, and may be moderately full, but any 
exertion may change its character and it becomes 
rapid, thready, small, and weak, being at times almost 
imperceptible. Nausea and vomiting may also be 
produced at this stage, with excessive muscular de- 
pression and weakness. The depressing action on the 
heart is the result of direct influence over the heart 
muscle and also over the inhibitory apparatus. The 
brain is not affected. 

Symptoms of Poisoning. 

Excessive doses of veratrum viride produce violent 
and alarming symptoms, but fatal results from it are 
rare, as vomiting is usually set up immediately. The 
nausea is intense and the emesis violent, the skin cold 
and clammy, and the pulse thread-like. 

Hiccough, faintness, and vertigo, partial uncon- 
sciousness, and loss of sight may be noticed among 
the symptoms of poisoning. Recovery has taken place 
after a teaspoonful dose of the fluid extract, and, in 
another case, the same amount caused death. 

Treatment of Poiso?iing. 

Emesis must be encouraged, and the stomach well 
washed out with warm water. The patient should not 



THE VEGETABLE KINGDOM. 25 1 

be allowed to rise during the act of vomiting, but to 
turn to the side, and afterwards, lying on his back, 
with the feet higher than the head, must maintain 
perfect rest. 

Alcoholic stimulants are used, and external heat is 
of importance, with gentle friction to excite the 
capillary circulation. 

Incidental Effects. 

The action of the skin is increased in an indirect 
way by veratrum and the secretion of bile is also 
stimulated. The temperature is quite markedly 
lowered by full doses, and various incidental effects, 
such as a feeling of heat and prickling, restlessness, 
anxiety, dizziness, dimness of vision, unsteady gait, a 
dryness of the mouth, with thirst, choking, nausea, 
and vomiting, may appear after medicinal doses. 

An eruption attended with itching is sometimes 
produced, appearing on the face and especially round 
the mouth. With suspension of the drug this soon 
disappears. 

In giving veratrum, if no special orders about the 
pulse have been given, it should not be allowed to fall 
below 70. A fall below 55 is dangerous. 

Preparations. 

Tinctura Veratri. 
Tincture of Veratrum. 

Strength 10 </<>. Dose, TTt v.-xx. (iTt x. = gtt. xxv.). 
(0.3-1.2 Cc.) 

Fluidextractum Veratri. 
Fluidextract of Veratrum. 

Dose, ttl i.-iii. (ttl i. = gtt. ii.). (0.06-0.2 Cc.) 

Norwood's Tincture is a saturated tincture and is unofficial. 

Veratrina (Veratrine). 

A compound of alkaloids contained in the seed of 
Asagrcea officinalis. 



252 MATERIA MEDIC A FOR NURSES. 

It is exceedingly poisonous, and is little used in- 
ternally. Poisonous doses cause convulsions and 
tetanus, with death from asphyxia. Externally it is 
irritant, causing prickling and tingling, redness of the 
skin, numbness, and vesication. The unguent is a 
powerful counter-irritant, but needs to be used with 
care, special pains being taken not to get it near the 
eyes, as it may cause violent irritation of the con- 
junctivae. 

The official ointment usually requires dilution. 

Preparations. 

Unguentum Veratrinae. 
Ointment of Veratrine. 

Strength, 4 $. For external use. 

Oleatum Veratrinae. 
Oleate of Veratrine. 

Strength, 2 <f . For external use. 

Colchici Semen (Colchicum Seed). 

Colchici Cormus (Colchicum Root). 

Meadow Saffron. 

The dried ripe seeds and corm 1 of Colchicum autum- 
?iale, found in Europe. The active principle is called 
colchicine. 

Physiological Actions. 

Colchicum is a sedative to the central nervous sys- 
tem; a diuretic ; and an irritant cathartic. It stim- 
ulates the liver, and excites the action of the skin. 
The urine, urea, and uric acid are increased in amount 
by moderate doses of colchicum. The pulse is slightly 
reduced in frequency — about 12 beats less to the minute 
being noticed while the impression lasts. 

1 A part of the stem which is underground, yet not the actual 
root — a bulb. 



THE VEGETABLE KINGDOM. 253 

Symptoms of Poisoning. 

Colchicum in poisonous doses is an aero- narcotic, 1 
producing a combination of nervous and gastro- 
intestinal symptoms. 

Nausea, violent and persistent vomiting and retch- 
ing appear first, with purging of serous, mucous, and 
bloody matters, attended with griping pain. 

Tenderness and burning are felt in the abdomen and 
stomach; the urine may be diminished or suppressed, 
while in some cases it is increased, and in others the 
kidneys seem unaffected almost to the last. 

Spasms occur frequently, and there may be fatal 
convulsions. The circulation fails, the pulse becomes 
rapid and grows feeble and thready, the skin is cold, 
livid, and covered with perspiration. 

Consciousness remains, and death results from 
collapse. 

The fatal dose is small, death having been caus<?d 
by 3 ss -ii. of the wine. 

Treatment of Poisoning. 

The only chemical antidote is tannin, though it is 
not always sure in its action. Emetics, with plenty of 
warm water, and castor oil must be given; albuminous 
drinks — milk, white of egg, etc. — and demulcents 
freely given, and stimulation used as the need arises. 

Incidental Effects. 

Colchicum, even in small doses, may produce un- 
pleasant secondary symptoms: dizziness, fulness and 
pain in the head; pains over the body; numbness, 
redness, prickling or smarting sensations; sneezing; 
running at the eyes; irritated fauces; coated tongue; 
loss of appetite or nausea; abdominal uneasiness or 
pain; flatulence or borborygmi; or rectal tenesmus 
may be observed. 

1 A poison which is irritant, and which also acts on the brain 
and spinal cord. 



254 MATERIA MEDIC A FOR NURSES. 

Preparations of Colchicum. 

Tinctura Colchici Seminis. 
Tincture of Colchicum Seeds. 

Strength, 10 <f>. Dose, 3 ss.-iss. (2-6 Cc.) 

Vinum Colchici Seminis. 
Wine of Colchicum Seeds. 

Strength, 10$. Dose, m x.- 3 i. (0.8-4 Cc.) 

Fluidextractum Colchici Seminis. 
Fluidextract of Colchicum Seeds. 

Dose, fT[ ii.-vi. (fll x. = gtt. xxv.). (0.1-0.35 Cc.) 

Nat. Ord. Graminacece. 
Ergota (Ergot). 

Ergot is a parasite which develops in rye, taking 
the place of the grain, and having the appearance of 
a blackish fungus. It is a complex substance, con- 
taining various alkaloids and acids; a fixed oil, etc. 

Three of the alkaloids are named ecboline, ergotine, 
and ergotinum; and the watery extract ergotin con- 
tains all the important constituents, and may be con- 
sidered to represent the active principles of ergot. 

Physiological Actions. 

Ergot is specially known as an oxytocic, exciting 
or increasing uterine contractions; and as a haemos- 
tatic. 

In the latter capacity it acts by contracting the 
small vessels, thus promoting coagulation. The fre- 
quency of the pulse is lessened by ergot, and very 
large doses depress the heart and vaso-motor centres 
and lower arterial pressure. 

It is not an active poison, and an ounce of the fluid 
extract has been given without producing serious 
symptoms. 



THE VEGETABLE KINGDOM, 2$$ 

Symptoms of Poisoning. 

In cases where poisoning has occurred the symptoms 
were thirst; gastric irritation and diarrhoea; a small 
pulse; burning pain in the feet; and sometimes ting- 
ling and cramps, dizziness, dilated pupils, and a feel- 
ing of cold. Before death there are convulsions. In 
European countries, where the poorer classes live 
largely on rye bread, chronic ergot-poisoning is 
familiar, and has at times prevailed as a scourge. 
There are two varieties of this chronic poisoning — the 
gangrenous and the spasmodic, — but it is unknown in 
this country, and need not be described here. 



Incidental Effects. 

The urine, perspiration, and milk are reduced in 
quantity by ergot. After taking medicinal doses, one 
or more of the following symptoms may be observed: 
an unpleasant taste in the mouth; tickling in the 
throat; nausea; burning pain in the stomach or abdo- 
men, with eructations of gas or diarrhoea; headache; 
lassitude; giddiness; specks before the eyes; unsteady 
gait; irregular pulse; chilly feelings. 

Fluidextractum Ergotae. 
Fluidextract of Ergot. 

Dose, TT[ x.- 3 i. (0.8-4 Cc.) 



Ergotin. 

Bonjean's preparation of ergotin is about ten or 
twelve times as strong as ergot — gr. v. or vi. represent- 
ing 3 i. of the drug. It is used hypodermically. 

It is irritant to the tissues and may produce abscesses, 
even when deepl}' given. 

Preparations of ergot lose their strength if kept for 
any length of time. 



256 MATERIA MEDICA FOR NURSES. 

Nat. Ord. Composites. 

Pyrethrum. (Pyrethrum ; Pellitory). 

Is the root of a perennial plant growing in northern 
Africa. It contains a volatile oil, resin, and pyrethrin, 
and is similar in nature to black pepper. It is a local 
irritant. It is a specific for bed-bugs, and the best 
remedy ever used for their destruction (Stiles). The 
pyrethrum powder, pyrethrum roseum, is dusted 
wherever the bugs exist, and they are exterminated. 
It should be used once every week for three weeks, 
in order to kill any bugs that may have hatched out 
in the meantime. 

Nat. Ord. Filices. 
Aspidium ; Filix Mas (Male Fern). 

The root-stock of Aspidium filix mas, a. European 
fern. The medicinal principle of fern is an oleoresin 
of a bitter, nauseous taste. 

It is an anthelmintic, specially destructive to the 
tape- worm. Although less irritating than some others 
of its class, it may, in overdoses, produce severe in- 
testinal irritation, and death has been caused in an 
adult by taking six ounces. 

Nat. Ord. Fungi. 
Agaricus. 

A fungus, called Polyporus offic'malis, white or 
purging agaric, which grows on the larch. 

In small doses it checks perspiration, the secretions 
of the bronchial tubes, the mammary glands, and the 
bowels. In large doses it is purgative. 

Agaricin. 

Dose, gr. \-\, in pill. (0.01-0.03 Gm.) 



THE VEGETABLE KINGDOM. 2$ J 

Nat. Ord. Lycopodiacece. 
Lycopodium. 

The dust, or sporules, which fills the spikes of a 
European moss. Collected in Switzerland and Ger- 
many, and used as a dusting powder for infants espe- 
cially; also for bed-sores, etc., either alone or mixed 
with bismuth. Locopodium is inflammable, and is 
sometimes called vegetable sulphur. It is a very soft, 
fine powder, and is used in rolling and packing pills 
and suppositories. 



THE ANIMAL KINGDOM. 
Lanolin. 

A combination of fats obtained from sheep's wool. It 
does not become rancid, nor form soaps, and is rapidly 
absorbed by the skin. 

It is used as a simple emollient, and as a means 
of introducing medicine into the system. 

Saccharum Lactis (Sugar of Milk). 

A crystallized sugar obtained by evaporation from 
the whey of milk, and specially suitable for use in 
preparing baby foods. It is soluble in one part boiling 
and seven parts cold water. 

Pepsin. 

Pepsin is one of the normal constituents of the 
gastric juice, and, with the aid of hydrochloric acid, 
changes albumins into peptones, in which form they 
are readily diffusible and capable of being absorbed 
into the blood. 

Pepsin, as used in medicine, is a preparation made 
from the mucous membrane which lines the stomach of 
the calf, sheep, or pig. 

It is made by cleaning the mucous lining, scraping 
it, drying the pulp at a temperature of ioo° F., and 
pulverizing it. The powder is a light yellow-brown, 
almost insoluble in water, and of slightly salty taste. 
It ma}' be taken dry on the tongue or given in milk. 

Dose, gr. ii.-v. (0.13-0.3 Gm.), with meals or 
immediately after. 

258 



THE ANIMAL KINGDOM. 259 

Pancreatin. 

A preparation made from the pancreas of the pig. 
Pancreatic extract digests starchy and proteid sub- 
stances, and pancreatin, while not given alone as a 
medicine, is very largely used in preparing artificially 
digested foods, viz.: pancreatized milk, eggs, oysters, 
soups, broths, etc. 

The principle followed in making pancreatized food 
is that by subjecting it to the action of pancreatin in 
the presence of moderate heat, the process of digestion 
takes place, and may be made complete or only partly 
so, according to the length of time during which they 
are in contact. 

The digestive process is stopped by heat at the 
boiling point, or by extreme cold. For this reason 
artificially digested foods, having reached the point 
desired, are either brought quickly to a boil or else 
are put on ice. 

Milk, if thoroughly digested, has a slightly bitter 
taste, which is not noticeable if the process has been 
short or complete. 

The ferments, pepsin, pancreatin, and diastase, 
which promised so much for dyspepsia, and all the ills 
of bad digestion, have passed into disuse, and even the 
use of alkalies and acids is not so prevalent as it once 
was, many physicians preferring to use remedies that 
strengthen the digestive organs and add to their 
normal function by putting them into a condition to 
furnish the ferments in proper consistency and propor- 
tion. Many of the patented digestive compounds con- 
tain diastase, and, while aiding the breaking up of 
starch in the alimentary canal, are detrimental to the 
cells and the function of the parts. 

Adeps Praeparatus (Prepared Lard). 

Lard consists of a fluid oil, olein, with stearin and 
palmitin, which are solid oils. 

It is used as the basis of various official ointments. 



26o MATERIA MEDIC A FOR NURSES. 

Benzoinated Lard. 

One part of benzoin to fifty parts of lard. 

Adeps Lanse (Wool Fat). 
The fat of the wool of sheep. 

Cetaceum; Spermaceti. 

A fatty substance obtained from the head of the 
sperm whale, and resembling white wax. 
It is used as an emollient. 

Oleum Morrhuae (Cod-Liver Oil). 

The oil obtained from the liver of Gadus morrhua, 
and other species of codfish. An exceedingly com- 
plex substance, containing glycerin, acetic acid, and 
several fatty acids, iodine, chlorine, and traces of 
bromine, phosphorus, and phosphoric acid, and various 
other constituents. There are three varieties: the pale 
yellow, light brown, and dark. The pale oil is the 
purest, being prepared by forcing steam at high pres- 
sure through the livers, and is less nauseous than the 
dark oil. 

Physiological Actions. 

Cod-liver oil is an alterative to the general nutrition 
in various diseased conditions, and is more truly a food 
than a medicine, as it supplies the need of the tissues 
for fat. Fat produces force, and is utilized by every 
part of the body in quantities directly proportioned to 
the activity of the different tissues. The nervous 
system needs the largest amount; the muscular, the 
next largest. Having been elaborated by the liver of 
the fish, cod-liver oil is more easily digested than 
other fats. 

The smell of cod-liver oil is unpleasant and some- 
times causes nausea. This may be avoided by taking 



THE ANIMAL KINGDOM. 26 1 

some peppermint into the mouth just before taking the 
oil, and by avoiding bringing it into direct line with 
the nose. All patients do not know how to take oil; 
by tossing it into the mouth and not allowing the lips 
to touch it, it is less disagreeable. 

It is best to mix no other medicines with cod-liver 
oil, except hypophosphites. If other medicines come 
at the same time they should be given separately. It 
may be given in any of the ways in which castor oil is 
given; it is almost always well taken if floated in a 
little brandy or wine, or lemon juice. These precau- 
tions about giving it do not necessarily apply to the 
various emulsions of oil, which are usually not at all 
hard to take. The proper time to administer cod- 
liver oil is when digestion is at its height. 

In overdoses, or when first taken, it may disorder 
the stomach, or cause temporary relaxation of the 
bowels. It sometimes causes an eczema. 

Emulsions of cod-liver oil spoil in a short time, and 
patients should not be encouraged to buy the ready- 
made preparations in the shops. 

In giving cod-liver oil the faeces must be watched, 
to see if any is carried away undigested. 

When cod-liver oil cannot be taken by mouth it may 
be administered by inunction, a few drams of the oil 
being rubbed into the skin of the chest or abdomen at 
night before retiring. When used in this way it is 
especially valuable for children with malnutrition. 

Dose, 3 i.- | ss. (4-16 Cc), from three quarters of 
an hour to an hour after meals. 

Cantharis (Cantharides ; Spanish Flies). 

The dried and powdered bodies of the Cantharis 
vesicatoria, a beetle of Southern Europe. The powder 
is grayish-brown and specked with minute greenish 
spangles from the wing-cases of heads. It has a 
strong unpleasant odor. The active principle is 
cantharidin, an active irritant, besides which it con- 
tains a volatile oil and fatty substances. 



262 MATERIA MEDIC A FOR NURSES. 

Physiological Actions. 

Externally cantharides is vesicant. When applied 
to the skin a feeling of heat and burning is felt in a 
few hours, and small vesicles form which unite in one 
large blister. 

The average time required for this result is about 
eight hours. The action of cantharides is attended with 
less injury to the skin than that of any other vesicant. 
No pus is formed during the healing process, and no 
scar is left by the blister. 

Internally cantharides is irritant to mucous mem- 
brane, and if given medicinally must be largely 
diluted. It enters the blood from the stomach and 
also from blistered surfaces, and is slowly excreted by 
the kidneys. In small doses it causes diuresis with 
some irritation of the urinary organs, and larger doses 
produce strangury. 

Symptoms of Poisoning. 

When a poisonous dose of cantharides is taken, the 
first symptoms are burning in the oesophagus and 
stomach, a constricted feeling about the throat, gastric 
and abdominal pain, with vomiting and in most cases 
diarrhoea. 

If the powder has been taken, the small green specks 
may be seen in the matter vomited, which is at first 
mucous, then bilious, and finally serous. The dis- 
charges from the bowels have the same characteristics 
and are scanty, frequent, and accompanied by tenes- 
mus. There is frequently salivation with swelling of 
the salivary glands. The pulse is weak and rapid, 
and death usually occurs quickly from collapse caused 
by the gastro- intestinal inflammation, but if it is 
delayed for a few hours the symptoms of irritation of 
the urinary apparatus appear, beginning with pains in 
the back, and ending in strangury, with scanty, albu- 
minous, or bloody urine, and tenesmus of the bladder. 



THE ANIMAL KINGDOM. 263 

Treatment of Poisoning. 

There is no antidote to cantharides, and the stomach 
must be at once emptied, and as thoroughly as possible 
washed out; large quantities of albuminous and muci- 
laginous drinks given; warm baths to relieve the 
strangury, and stimulants if necessary. No oils or 
glycerin must be given, as they aid in the absorption 
of the poison. 

It is to be remembered that constitutional effects are 
sometimes produced by even a moderate blister, and if 
necessary the blister must be removed and the part 
washed with soap and water. 

Cautions. 

Before applying a blister the spot should be washed 
with soap and water; dried; washed again with alco- 
hol or ether, and briskly rubbed for a moment or two. 
Absorption then takes place more quickly. A blister 
should never be applied over a bony prominence, as 
sloughing may follow, the circulation in such parts 
being sluggish. On tender skins vesication is soon 
produced and the blister must be carefully watched 
lest the action be too severe. On coarse skins, or in 
places where it is thick, as on the scalp or at the knee- 
joint, more time is needed. 

Hairs must be cut away, or shaved. A blister 
should not be left on a child's skin long enough to 
rise, but should be removed when redness appears, and 
poultices be applied to finish the process. 

Glandulae Thyroideae Siccae. (See p. 282.) 
Desiccated Thyroid Glands. 

The thyroid glands of the sheep, dried and pow- 
dered, producing a }'ellowish powder, with a slight, 
peculiar odor, and soluble, partially, in water. 

Dose, gr. ii.-vi. (0.13-0.38 Gm.) 



264 MATERIA MEDICA FOR NURSES. 

Glandulae Suprarenales Siccae. (See p. 281.) 
Desiccated Suprarenal Glands. 

The suprarenal glands of the sheep or ox, dried and 
powdered, producing a yellowish-brown powder, par- 
tially soluble in water. 

Dose, gr. ii.-vi. (0.13-0.38 Gm.) 

Serum Antidiphthericum. 
Antidiphtheric Serum. Diphtheria Antitoxin. 

A fluid separated from the coagulated blood of a 
horse, immunized by inoculation with diphtheria 
toxin. It is a yellowish-brown powder, odorless, and 
slightly transparent. It loses strength, and the date 
of its manufacture should be known, also its strength, 
the name of the preservative, and the date beyond 
which it will not retain its strength. The standard 
should be that approved by the United States Public 
Health and Marine Hospital service. 

Dose, 3000 units. 

Immunizing dose, 500 units. 

Immunizing dose for children, 300 units. 



POISONS AND THEIR TREA TMENT. 

Poisons may be conveniently classified in three 
groups : 

i. Corrosives, or those which act rapidly at the point 
of contact with the tissues, causing erosion. Such are: 

Acids, alkalies, corrosive salts, animal and vegetable 
poisons, and gases. 

2. Irritants, or those which irritate the tissues at 
the point of contact, and may cause erosions if con- 
centrated for any length of time on the tissues. This 
group includes alcohol, ether, the metals, and some 
salts, carbon monoxide, phosphorus, and turpentine. 

3. Functional, or those which act upon the function 
of organs or systems. Here we have aconite, bella- 
donna, chloral, C0 2 , gelsemium, lobelia, strychnine, 
opium, hemlock, mushrooms. 

In group 1 death is usually sudden. If not immed- 
iate, then administer by mouth the antidotal treatment. 
Do not use the stomach-tube unless there is little ero- 
sion. Emetics are employed with great risk in these 
cases. The stomach-pump is always preferable, even 
with great erosion. 

In group 2 the first thing to do is to insert the 
stomach-tube and wash out the stomach thoroughly. 
Emetics may be employed instead. Cathartics may be 
given and antagonistic treatment if necessary. Oils, 
milk, eggs, and demulcent drinks are useful. 

In group 3 treatment should proceed according to 
the drug that caused the poisoning, and according to 
the symptoms that develop. 

In poisoning from snake bite or scorpion sting, use 
a one-per-cent. solution of chromic acid locally, and 
give strychnine r^podermically. Use no alcohol. 

In any case, keep cool ; take o?ie minute to collect 
yourself, then go to work. Command others. The 
result may surprise you, even in the most hopeless 
cases. 

265 



A TABLE OF POISONS, 
THEIR ANTIDOTES AND ANTAGONISTS. 

Antidotes act upon the poisons in the alimentary- 
canal, and by combination or removal prevent their 
toxic action. 

Antagonists counteract the effect of the poison upon 
the system, and may be used after its absorption, when 
antidotes are too late. 



Acids — 
Sulphuric. 
Nitric. 

Hydrochloric. 
Phosphoric. 



Carbolic. 



Oxalic. 

Tartaric. 

Acetic. 



Hydrocyanic. 



Aconite. 



CHARACTERISTIC 

EFFECT. 



I/)cal action— corro- 
sive. 



Rapid action 
lapse. 



col- 



Freguent accidental 
mistake — Epsom 
salt. 60 % die. 

Acts too quickly for 
any antidote to be 
of use. 



A few drops kill ! 
Tingling sensation. 



ANTIDOTAL 

TREATMENT. 



Alkalies — as Soda, 
Magnesia, Chalk, 
I/ime-water, 
White-wash, Soap. 
Oil; Albumen; Milk. 
Demulcent drinks. 

50$ alcohol. 

Stomach-tube. 

L,ime-water; Syrup 
of Iyime. 

Milk. 

Vegetable demul- 
cent drinks. 
No oil. 

Stomach-tube. 
Iyime with water or 

milk. Emetics. 
Bland drinks. 

Stomach-tube. 
Emetics. 



Stomach-tube. 
Empty and wash 
out stomach. 



ANTAGONISTIC 
TREATMENT. 



Stimulants. 
Opium for pain. 



Atropine. 
Chloral? 
Stimulants. 
External heat. 



Stimulants. 
External heat. 



respira- 



Artiflcial 

tion. 
Stimulants, hypo 

dermically and by 

inhalation. 
Cold water to head 

and spine. 

Recumbent position. 

Artificial respira- 
tion. 

Heat. Atropine. 

Hypo Ether, Digi- 
talis. 



266 



A TABLE OF POISONS. 



267 



Alcohol. 



Alkalies — 
Ammonia. 
Caustic Potash. 
Caustic Soda. 
Ivime. 

Anaesthetics- 
Chloroform. 
Ether, etc. 



Antimony — 
Tartar Emetic. 
Wine of Anti- 
mony. 
Syrup of Squills. 

Arsenic — 
Fowler's Solu- 
tion. 
Paris Green. 
Rough on Rats. 
Arsenous Acid. 



Belladonna— 
Atropine. 
Hyoscyamus and 
Stramonium 



Chloral. 



Cocaine. 



Copper. 
Bluestone, etc. 



Digitalis. 



CHARACTERISTIC 
EFFECT. 



Acute — maiden- 
blush. 
Chronic — nosegay. 



Dissolve tissues. 
Cause rupture or 
stricture. 



Produce sleep. 



Rarely used. 
Cause vomiting. 



Acute — "rice water 

stools." 
Chronic— puffy eyes 



Wild as a hare, dry 
as a bone, red as a 
beet!" 



With alcohol — 
"knock-out 
drops." 



Hypodermic habit. 
Two grains poison. 



Causes vomiting. 



Irregular circula- 
tion. 



ANTIDOTAL 
TREATMENT. 



Stomach-tube. 
Emetics. 



Dilute acids. 

Vinegar. 

Lemon juice. 

Milk. 

Oil. 



Remove anaesthetic. 



Stomach-tube. 
Wash out stomach. 
Tannic acid — as tea, 

etc. 
Demulcent drinks. 

Stomac h - tube. 
Emetics. Hy- 
drated Oxide o f 
Iron with Mag- 
nesia. Dialyzed 
Iron. Demulcent 
drinks. 

Stomach-tube. 
Emetics. 
Tannic acid. 



Wash out stomach 
with tea or coffee 
and give these per 
rectum. 



Remove cause. 
Stomach-tube. 



Albumens — egg, 

milk. 
Wash out stomach 

after. 
Demulcents. 

Stomach-tube. 
Emetics. 
Tannic acid. 



ANTAGONISTIC 
TREATMENT. 



Cold to head; heat to 
extremities. In- 
halation of Am- 
monia. 

Electricity. Coffee. 

For Ammonia — 
Aconite. 
Digitalis. 
Cold air. 



Artificial respira- 
tion. 

Inversion of patient. 

Atropine ; Strych- 
nine. 

Stimulants. Heat. 

Opium for pain. 
Alcohol. 



Stimulants. 
Opium for pain. 



Chloroform, Ether, 
Caffeine. 

Artificial respira- 
tion. 

External stimulants. 

Heat. Mustard ap- 
plications. 

Artificial respira- 
tion. 

Alcoholic stimu- 
lants. 

Atropine (carefully). 

Alcohol. Opium. 
Chloroform . 
Nitrite of Amyl. 



Recumbent position. 
Aconite ? 
Stimulants. 



268 



MATERIA MEDICA FOR NURSES. 



Gases — 

Illuminating. 
Carbon dioxide. 
Chlorine. 
Nitrous Oxide. 



Gelsemium- 
Coniine 
Sparteine. 



Iodine. 



Lead- 
Sugar of Lead, 
etc. 



Lobelia. 



Mercury — 
Corrosive Subli- 
mate, etc. 



Mushrooms 
(non -edible). 

Nitrate of Silver- 
"Lunar Caustic. 

Opium- 
Laudanum. 
Paregoric. 
Morphine, etc. 



Phosphorus. 



Strychnine. 



CHARACTERISTIC 
EFFECT. 



Anaesthetic. 



Depressing heart 
and respiration. 



Colored vomitus. 



Acute — causes vom- 
iting. 

Chronic — colic, par- 
alysis, blue gums. 



Causes vomiting. 



Acute — corrosive. 
Chronic — salivation 
etc. 



Lake the blood. 
Paralyze the heart. 



Scarification. 



" Pin-point pupils. 
Odor of breath. 



Garlic odor. 



Convulsions. 



ANTIDOTAL 
TREATMENT. 



Remove patient 
from gas. 



Emetics. Stomach- 
tube. 



Starch or flour with 

water. 
Stomach-tube. 
Emetics. 

Dilute sulphuric acid 
and lemon juice. 

Magnesia. A 1 b u - 
mens. Stomach- 
tube. Emetics. 

Tannic acid to wash 
out stomach. 

White of an egg to 
4 gr. of the poison 
Milk, flour. 
Stomach-tube. 

Wash out stomach. 
Cathartic. 



Common salt. 
Stomach-tube. 

Stomach-tube. 
Emetics. 

Permanganate of 
Potassium. 



Stomach-tube. 
Emetics. 

Copper Sulphate. 
No fats or oils. 
Old oil of Turpen- 
tine. 

Tannic acid. 
Stomach - tube or 
emetic quickly. 



ANTAGONISTIC 
TREATMENT. 



respira- 



Fresh air. 

Artificial 
tion. 

Stimulants. 

Oxygen inhalation. 

Friction of body sur- 
face. 

Opium? Stimulants. 
Artificial respira- 
tion. 
Heat. Electricity. 

Stimulants hypoder- 
mically. 



Opium for pain. 
External heat. 



Stimulants. 
Strychnine. 



Atropine. 
Stimulants. 
Salt infusion . 



respira- 



Artificial 
tion. 

Electricity. 

External heat (care- 
fully). 

Coffee by mouth and 
rectum. 

Atropine (with care). 

Alkalies. 
Heat. 



Quiet. Chloroform 

for convulsions. 
Chloral. Opium. 



A TABLE OF POISONS. 



269 





CHARACTERISTIC 


ANTIDOTAL 


ANTAGONISTIC 




EFFECT. 


TREATMENT. 


TREATMENT. 


ADDENDA. 
Chlorates. 


Depression. 
I,ake the blood. 


Stomach-tube. 


Stimulants. 
Alkaline drinks. 
Diuretics. Water. 


Coal Tar Antipy- 
retics — 
Antifebrin. 
Antipyrin. 
Acetanilid, 
Phenacetin, etc. 


Depression. 
I^ake the blood. 


Stomach-tube. 
Stop drug. 


Stimulants. 

Heat. 

Oxygen inhalation. 


Cantharides. 


Blisters. 


Stomach-tube. 
Emetics. 
Epsom salt. 
Demulcents. No oil. 


Stimulants. 
Heat to abdomen. 
Opium for pain. 



EMETICS. 

The use of drugs to produce emesis is not so prev- 
alent as it was years ago, and if it becomes necessary 
to cause vomiting, the simpler means (such as drink- 
ing large draughts of tepid water and putting one's 
finger down the throat) should be tried whenever 
possible. 

Stomach -tube. — We have at present in the stomach- 
tube an efficient means of emptying the stomach, and 
one that is simple, easily accomplished, and does not 
cause the patient great inconvenience and danger as 
in the use of zinc or copper sulphate, ipecac or tartar 
emetic, provided one is acquainted with the use of the 
stomach-tube. For ordinary stomach washing, etc., 
the patient should be seated in a chair and a rubber 
sheet placed around the neck, the end of the sheet 
resting in a basin between the patient's feet. The 
tube should be taken from cold water and passed care- 
fully and rapidly down into the stomach, the operator 
standing behind the patient and grasping the tube 
firmly with the fingers of t!ie two hands. The patient 
should be told to hold the head forward and allow the 
tube to pass down the throac. As soon as a feeling of 
choking or shortness of breath is experienced a deep 
breath should be taken. The tube should enter to a 
distance of about 30 cm. The stomach may then be 
washed out with warm water, and such drugs as neces- 
sary administered, leaving them in the stomach. While 
operating, the tube should be held firmly just at the 
patient's teeth that it be not forced out by reflex peri- 
stalsis of the oesophagus, or by other means. 

Mustard. — One teaspoonful of mustard to a teacup- 
ful of warm water may be given to produce vomiting. 

270 



EMETICS. 271 

Repeat in ten minutes, if necessary, and keep on re- 
peating until the desired effect is produced. Be sure 
that the mustard is removed from the patient's stomach 
before leaving him. Mustard should not be used in 
any condition of inflammation of the stomach. 

Soap-suds ; Salt. — Either of these in small amounts 
with tepid water will prove effective in producing 
vomiting and is to be used in preference to more drastic 
remedies. 

Ammonium Carbonate. — This is a very safe and 
effective emetic, being at the same time a rapidly dif- 
fusible stimulant and expectorant. It may be given in 
doses of gr. 30 (Gm. 2.0), largely diluted, and in milk. 

Ipecacuanha. — The action of this drug is similar to 
that of the above, but it is slower in its action. It is 
used as an aid to other emetics, or for children to assist 
expectoration, or in old persons, or those who are very 
weak. It is safe and not depressing. Dose, 4-6 fl. 
dr. (16-24 Cc.) of the wine of ipecac, given every 
quarter of an hour until the desired effect is produced. 
Large draughts of tepid water hasten its action. 

Apomorphine. — Apomorphine is injected hypoder- 
mically when rapid action is necessary, when the 
stomach is inflamed, or if the patient is unable to 
swallow. It should not be given unless the nervous 
mechanism is intact. After irritant, corrosive, or nar- 
cotic poisons the stomach-tube is better. Dose, gr. 
■ftri (Gm. 0.006-0.01). Vomiting usually takes place 
in from four to ten minutes. Repeat with caution, if 
necessary. 

Sulphate of Zinc. — This is a specific emetic, acting 
promptly, without absorption, and causes little nausea 
or depression. Dose, gr. 15-20 (Gm. 1.0-2.0), largely 
diluted with warm water and repeated in fifteen min- 
utes if necessary. 

Sulphate of Copper. — This is rarely employed as an 
emetic, but is rapid in its action when used. It is ex- 
tremely irritant and should not be repeated if not at 
first effective. 

Tartar Emetic. — This old remedy has fallen into 



272 MATERIA MEDICA FOR NURSES. 

disuse on account of its depressing effect and slow re- 
sults. Any dose large enough to produce emesis also 
produces depression both before and after the act of 
vomiting, and the patient is usually left in an ex- 
hausted if not critical condition. Dose, gr. T V : (Gm. 
0.003-0.06). 






HYPODERMIC ADMINISTRATION OF 
DRUGS. 

This method of giving drugs is growing steadily in 
favor. The best location for the injection of a drug is 
in the extensor surfaces of the extremities, and in the 
back, chest, or abdomen, avoiding the region of large 
blood-vessels and nerves. The amount administered 
is about one half the dose usually given by mouth. 
Nearly all drugs used hypodermically are put up in 
tablet form, being made readily soluble and especially 
for the purpose. The nurse becomes familiar with the 
various forms and sizes of syringes in use for the giv- 
ing of hypodermics, and the care and sterilization of 
these is a part of her instruction from nursing text- 
books and in practice in the wards of her hospital. 

There are two ways of making the injections, super- 
ficial and deep. In the first, after having used at least 
two successive applications of alcohol by means of a 
sterile sponge or a bit of absorbent cotton to cleanse the 
part, the skin is grasped between the thumb and 
fingers of the left hand while the needle is thrust with 
the right hand on a slant to the depth of one centimetre, 
when it is withdrawn a short distance and the fluid is 
slowly forced into the tissues. Gentle kneading 
around, but not on, the point of injection and slight 
pressure over the part will aid in the absorption of the 
fluid, help to prevent abscess formation, and allay 
pain. 

The second method, deep or intramuscular injec- 
tion, is useful with irritant drugs, and with the same 
precautions as in the other method the needle is in- 
serted deeply and swiftly into the muscular tissues of 
the back, chest, abdomen, buttocks, or preferably the 

18 

273 



274 MATERIA MEDICA FOR NURSES. 

anterior surface of the thigh, to the depth of three to 
five cm., at the same time stretching the skin tight 
over the part. The fluid is forced quickly out of the 
syringe, and the tissues around the point of its inser- 
tion are kneaded deeply for about five minutes. 

Morphine and Strychnine. — These drugs are usually 
injected superficially about the fleshy part of the shoul- 
der. They may be put in lower down on the arm or 
in other parts of the body. 

Cocaine. — This is usually administered as a local 
anaesthetic, and in this way may be injected into any 
part of the body, or dropped into the eye or ear, or 
sprayed into the nose or throat. For hypodermic in- 
jections, the needle should be inserted along the line of 
the proposed incision — when one is to be made — and 
the cocaine forced in, a little at a time, removing the 
needle and reinstating it within the limit of anaesthesia 
with every Cc. of the fluid used. The injection should 
be completed at least five minutes before the incision is 
made. Not more than two grains of cocaine should 
be administered at one time for fear of poisoning. 

Antitoxin.— -One usually administers this remedy 
into the tissues of the back, buttocks, or thigh, pref- 
erably between the shoulder-blades or in the lumbar 
muscles. Rubbing and kneading the region adjacent 
to the point of injection is an aid to the efficiency of 
the injection. 

Salt Solution. — The apparatus necessary for this is 
a graduated bottle, a rubber tube, and a needle. Ster- 
ilized normal salt solution (.9 of 1 <f ) should be kept 
on hand, and when wanted for use heated to a tem- 
perature of no° F. and maintained at that point, em- 
ploying a thermometer to register it. The bottle should 
be suspended at a height of three to six feet above the 
patient. The fluid is injected into the tissues behind 
the breast or into the thigh. The needle should be 
inserted well into the tissues, and withdrawn a little 
way. An adhesive strip may be used to hold it in 
place. Do not become alarmed if a large swelling 
occurs. Persistent kneading of the tissues around this 



HYPODERMIC ADMINISTRATION OF DRUGS. 275 

will reduce it. A lineu band may be placed about the 
patient's chest to prevent swelling, but this is un- 
necessary. Twenty minutes to one-half hour is usually 
required for 500 Cc. to infiltrate the tissues. 

Mercury is used in the form of the bichloride, or gray 
oil, and is injected deep into the buttocks, as a rule. 

Ether, camphor, ammonia, alcohol, and caffeine are 
all injected into the muscles and are so used to obtain 
the rapid stimulating effect of the drugs. 

Digitaline, ergotine, and arsenic in the form of 
atoxyl, are put in deep. 

Atropine, quinine, nitroglycerin, pilocarpine, adren- 
alin, hyoscine, and eserine are also used hypodermically, 
and may be administered superficially. 

Gelatin has been injected subcutaneously, but its 
use is becoming limited. Other drugs may be used 
hypodermically. 

Piqures. 

The Italians administer iron, arsenic, and strych- 
nine, as well as guaiacol and other drugs, as tonics by 
hypodermic injection, calling the custom the giving of 
" piqures." The drug is prepared and hermetically 
sealed in a thin glass tube about 3 cm. long and contain- 
ing 3 Cc. of the fluid ready to be used in the syringe 
after the neck of the tube is broken off by snipping it 
with a pair of scissors. One injection is given each day 
into the gluteal muscles, on alternate sides. The 
injection is administered deep as above described. 
About 30 minims or an ordinary syringeful is the 
amount given, and the fluid is forced in rapidly, the 
quicker the less painful. Abscesses are not known to 
occur except through gross carelessness in technique. 
Strict asepsis is, of course, necessary. 



SERUM THERAPY. 

The revival of an ancient principle of treatment 
practised by Mithridates in his empire is of recent 
occurrence. We read that " Mithridates believed it 
possible to render himself proof against all forms of 
poison by the constant and daily use of small doses of 
various poisonous principles, and he compounded a 
general antidote by combining all forms of poison then 
known. He mixed with this the blood of geese and 
used the remedy for snake bite, reasoning that the 
geese must have some antidote for snake venom in 
their blood, because one of the chief articles of their 
diet was the viper, to whose bite they were very 
resistant." At the present time we use the serum 
from the blood of animals that have been treated with 
a killed culture of bacteria, or the toxins caused by 
bacteria, until the animals become immune to the kind 
of bacteria or toxins used. Ehrlich explains this im- 
munity by his side-chain theory. His idea is that the 
body cells have groups of characteristics which may 
link them to certain substances. Toxins contain two 
groups of properties, the toxaphore group, which exerts 
its influence on the body cells, and the haptophore 
group, which combines the toxaphore group or toxic 
element with the haptophore group in the tissue cells, 
forming a side chain to the cells. The haptophore 
groups of the cells are destroyed, but nature quickly 
replaces them, producing more than were destroyed, 
the excess being liberated into the blood. This excess 
is called antitoxin. The antitoxin has an affinity for 
the haptophore group in the toxin, and by combining 
with the latter in the circulation protects the tissue 
cells by rendering the toxin inert. The injection of 

276 



SERUM THERAPY. 2JJ 

antitoxin gives immunity — as in tetanus — if admin- 
istered before the toxin is introduced into the system, 
or cures — as in diphtheria, — in some cases, if admin- 
istered after the toxin has entered the system. This 
is antitoxic immunity. Bactericidal immunity is more 
complex. When bacteria enter the body they cause 
the tissue cells and other cells to throw off an immune 
body (amboceptor) which can destroy the bacteria only 
by linking them to the co?nplement which is contained 
in the bodies of all beings. The immune body is the 
protective agent. Much could be hoped from bacteri- 
cidal sera could they be obtained so readily as anti- 
toxin, but great difficulty has been experienced in 
procuring such sera. We have then two kinds of sera: 
antitoxic, such as antitetanus, antidiphtheritic, and 
anticellular; and antibacterial, such as antipneumo- 
coccic, antityphoid, and antiplague. 

Classifications of Antitoxins, Serums, Vacci?ies, and 
Extracts. 

A. Vaccines. 

i. Cultivations. 

a. Containing pathogenic micro-organisms; such 
as anthrax, one form of cancer vaccine, cholera 
vaccine, Coley's fluid, Haffkine's plague vac- 
cine, tuberculin and T. R. of Koch, typhoid 
vaccine of Wright. 

b. Containing toxins only; such as one form of 
cancer remedy, diphtheria toxin, mallein, 
tetanus toxin, and tuberculin Koch (?). 

2. a. Tissues of animals suffering from an infectious 
disease; such as malignant oedema and rabies. 
b. Fluids of animals suffering from an infective 
disease; such as vaccine lymph, and glycerinated 
calf lymph. 

B. Anti- Serums — A?itidiphtheritic and Antitetanic 

Serums. 
i. Antitoxins; such as antipneumonia, antivenene, 
and diphtheria and tetanus antitoxins. 



278 MATERIA MEDICA FOR NURSES. 

2. Antibacterial; such as cancer antibacterial serum, 
' cholera antibacterial serum, antileprosy serum, 
antitubercular serum, antirabic serum, anti- 
streptococcic serum, antityphoid serum, and 
Yersin's plague serum. 
C- Animal Tissue Extracts — Organo -Therapy. Bone 
marrow, thyroid extract, and suprarenal extract 
are the chief of these. 

(Sims Woodhead's Classification.) 

Diphtheria antitoxin is prepared as follows: A 
colony of diphtheria bacilli, after being placed in a suit- 
able medium and under favorable conditions, multiply 
with great rapidity, secreting at the same time their 
poison or toxins. After a few weeks, when sufficient 
of the toxin has formed, the bacilli are destroyed by 
means of carbolic acid, and by filtering through porous 
plates of clay the dead bacilli are removed from the 
solution of toxins. Of this solution small amounts 
are injected into the blood of a healthy horse, produc- 
ing a mild attack of the disease; this procedure is then 
repeated for several months, the doses of toxin being 
steadily increased until the animal becomes habituated 
to the poison. Then a quantity of blood is withdrawn 
from the animal, and the serum, or aqueous portion, 
is separated from the red blood corpuscles, this serum 
constituting a light yellow liquid which contains the 
antitoxin of diphtheria. The serum is standardized 
by determining the quantity required for injection to 
neutralize a fatal dose of diphtheritic poison in a guinea- 
pig; the ratio between the quantity of antitoxin and 
the body weight of the animal furnishes a means of 
indicating in definite units the strength of the solution. 

Behring's. — No. 1 equals 600 immunizing units; No. 
2, 1000; No. 3, 1500. In \ oz. vials, varying measure 
but full unit value. 

Gibiefs (N. Y. Pasteur Institute). — Identical with 
Roux's. Immunizing power, 1: 100,000 — i. e., £ Cc. 
prophylactic up to no pounds; regular treatment, 
5-15 Cc. a day. 



SERUM THERAPY. 2jg 

Roux's. — Same description as Gibier's. 

Schering-Aronson — Supplied in vials containing 5 
Cc, equivalent to 500 antitoxic normal units. 

Every case of diphtheria should be treated with the 
antitoxin as early as possible, 3000 units being an 
average first dose. All persons exposed should be 
given an immunizing dose of 500 units, except children 
under two years, with whom 300 units is sufficient, 
repeating the dose every three weeks in any case, until 
all danger is past. The antitoxin is used as directed 
under " Hypodermics." 

Rabies Antitoxin, for Hydrophobia. — Pasteur founded 
the system of treating rabies by the injection of an 
emulsion of the spinal cord, believed to contain the 
poison, no bacilli being yet found. The rabies poison 
having a special affinity for the spinal cord, rabbits are 
inoculated with poison obtained from sections of the 
spinal cord at different stages of treatment. In the end 
an immunity is set up in the animals; an anti-rabic 
virus is obtained and injected into persons bitten by 
mad dogs. Pasteur Institutes, where treatment is pro- 
vided for those bitten by animals, are located at con- 
venient points throughout the United States. The 
treatment costs about one hundred dollars. 

Tetanus Antitoxin has not proved satisfactory as a 
curative agent, but has been of some benefit, and is 
very effective as a prophylactic. Its method of prep- 
aration is analogous to that of diphtheria antitoxin, 
and it is similar to this in nature and action. It is put 
up in two forms, viz., as a dry powder, which is used 
for the treatment of developed cases of tetanus in man 
or animals, and as a liquid, which is employed as a 
prophylactic. The dry antitoxin is designated as a 
hundred-fold normal antitoxin — i. e., 1 gm. is sufficient 
to neutralize 100 gm. of the normal poison of tetanus. 
It is put up in 5 gm. vials, this quantity being theo- 
retically sufficient to effect a cure. The vialful is 
dissolved in 30 Cc. of sterilized water at 40 C, and 
injected hypodermically at a single dose. The liquid 
form is of fivefold normal strength, and is employed 



28o MATERIA MEDICA FOR NURSES. 

hypodermically in cases of wounds where there is 
reason to fear development of tetanus, in quantity 
proportionate to the condition of the patient and the 
length of time elapsed since the injury. The antitoxin 
should not be kept long because it spoils readily. It 
should be injected in the same way as diphtheria anti- 
toxin. Large doses used thoroughly will influence 
many cases of tetanus favorably if anything will. 

Antityphoid Serum is prepared in much the same 
way that the antitoxins are prepared, but the im- 
munizing period in the horse is much longer, being 
about one year. In cases of typhoid fever the Chante- 
messe serum is injected into the flexor surface of the 
elbow, about the plexus of large veins, in doses of 8-10 
Cc, and in a week, if the fever persists, 4-10 Cc. are 
again injected. A prophylactic dose of 2 Cc. may be 
used for those exposed to the disease. 

Antiplague Serum made by Yersin has proved of 
value in treating the bubonic plague. It is given in 
doses of 150-300 Cc. 

Tubercular Serum- (Behring, Koch, Fisch, or Mara- 
gliano) is used in the treatment of early cases of 
tuberculosis where there is no mixed infection, in a 
gradually increasing dose of 0.2-2 Cc. over a period 
of two years. Tuberculin (Koch), prepared by extrac- 
tion of pure cultures of tubercle bacilli with 40-50 <f 
glycerin and repeated precipitation with alcohol, as a 
snow-white mass soluble and stable in 50 % glycerin, 
is used in the diagnosis of local and pulmonary tuber- 
culosis. The characteristic reaction to an injection of 
tuberculin shows itself locally by increased heat and 
systemically by a rise in temperature, usually in 12 
hours. It is injected between the shoulder-blades at 
night in doses of ^io~sV g r - (i" 1 m g-) 

Vaccine, Glycerinated Calf Lymph. — This comes in 
small sealed glass tubes in sterile form and is the best 
and safest lymph for vaccination. It has been adopted 
by the British Government and is recommended by the 
local Government Board in the United States. The 



SERUM THERAPY. 28 1 

tubes may be large or small, and will vaccinate from 2 
to 80 persons, depending upon the size of the tube 
used. 

Antivenene {serum antivenineux , Calmette) is pre- 
pared from the blood of asses and horses which have 
been immunized against snake poison. The power of 
immunization is 1 in 10,000. It should be carried by 
all persons going to a district infested with snakes, 
especially in India. The dose for adults is 20 Cc.; 
for children, 10 Cc; in very dangerous cases the dose 
is doubled. 

Antistreptococcus and Antipneumococcus sera have not 
proved to be distinctly valuable, although the former 
may do good, and can do no harm in general infections, 
erysipelas, and scarlet- fever. Large and frequent doses 
are required. 

Many other sera have been exploited, among them 
anticholera, antidysentery, antiscarlatina, and those for 
the cure of yellow fever, anthrax, glanders, leprosy, 
whooping-cough, erysipelas, syphilis, malaria, and hay- 
fever, but none of these has yet proved of any practical 
value. 

Red Bone Marrow Extract. —The marrow of ox-bone 
and sheep-ribs has been used as a remedy for chronic 
debilitating blood diseases. It comes in the form of 
tablets containing one grain of the desiccated marrow, 
equal to twenty grains of the substance in its natural 
state. Each tablet weighs three grains. Dose, 1-3 
tablets. 

Suprarenal Gland. 

The active principle of the gland, epinephrin, has 
been isolated by Abel and Crawford, but it is not used 
in therapeutics. The dried extracts of the whole gland, 
or a liquid extract, or adrenali?i may be used. These 
preparations are notable for causing contraction of 
small blood-vessels when applied locally, blanching 
the skin or mucous membrane, and for a general tonic 
effect on the heart and arteries when given internally. 



282 MATERIA MEDICA FOR NURSES. 

They strengthen the heart's action and slow and regu- 
late the pulse, causing a rapid rise in blood pressure. 

Adrenalin Chloride Solution. 

Dose, lit. v.-xxx. (0.3-1.8 Cc.) by the mouth. Diluted 
with normal salt solution ten times it is used as a 
hypodermic injection, and has been suggested for in- 
travenous injection. It is injected with cocaine and 
eucaine to cause anaesthesia and bloodless operations. 
For spray inhalations the strength of 1 to 2500 or 1 to 
5000 is effective. The solution is easily oxidizable and 
should be kept closely stoppered and away from the 
light. 

Thyroid Gland. 

This gland, and preparations made from it, have 
been used in myxoedema, cretinism, and allied con- 
ditions, by feeding the gland, by grafting, by the exhi- 
bition of the official thyroid preparation by mouth or 
hypodermically, or by dry thyroid in powders, cachets, 
or tablets. 

Liquor Thyroidei, Thyroid Solution. — Dose, V\. v.-xv. 
(0.3-0.9 Cc.) fresh. This official preparation does not 
keep well and must be freshly made of the gland with 
glycerin and water. 

Thyroid mixtures should be prescribed with chloro- 
form water. 

Thyroideum Siccum t Dry Thyroid. — Dose, gr. iii.-x. 
(0.2-0.65 Gm.) in cachets. 

Iodothyrin contains 0.03 f iodine. Tablets, gr. v. 
each (0.32 Gm.). 



RADIOLOGY. 

The "X" rays discovered by Roentgen in 1895 are 
used extensively to locate foreign bodies, as a means 
of diagnosis of fractures, tumors, calculi, etc., and in 
the treatment of superficial diseases of the dermis and 
epidermis. Lupus, rodent ulcer, and other skin affec- 
tions seem to be best treated by a combination of the 
"X" rays and the Finsen light, which is a concen- 
trated light produced by an arc lamp in which the heat 
rays are cut off, leaving only the violet or ultra-violet 
rays to penetrate. Red light is employed to prevent 
tbe pitting of small-pox. Reflected sunlight has been 
used successfully for superficial tuberculosis. 

Radium is obtained from pitchblende residues, 
usually in company with urauium. Radium rays are 
of three kinds, A, B, and Y, of which the last is the 
most penetrating and resembles the "X" ray in its 
action. Diseases which the "X" rays and the 
Finsen light had failed to cure were rapidly cured by 
the use of radium. Blondlot's " N " rays are said to 
increase the phosphorescence induced by radium. 
These rays are highly penetrating, and appear to be 
emitted by general sources of heat and light. Rays 
similar to these from the human frame affect a sen- 
sitive screen. Plants are also said to emit these rays. 



283 



MINERAL WATERS. 

Aix-les- Bains (Savoy) contains sulphur and a curi- 
ous organic matter called Baregine, which renders it 
easy of digestion, oily, and suitable for massage. It 
is anti-rheumatic in action. The resort is open nearly 
all the year; the season of greatest benefit is from April 
i st to November ist. 

Aix-la-Chapelle (Aachen, Prussia) is a sulphurous 
saline water containing sodium chloride, sodium bicar- 
bonate, sodium and potassium sulphates, sulphuretted 
hydrogen, and carbonic acid. The water may be 
imported, and is drunk or used for baths. The two 
seasons extend from May 15th to September 30th, and 
from September 15th to March 31st. 

Alexanderbad (Bavaria) is a chalybeate water con- 
taining iron and manganese. The season extends 
from May 15th to October ist. 

Alexisbad (Germany) has three springs of chaly- 
beate water: Alexisbrunnen, Schonheitsquelle, and 
Stahlbrunnen or Grotte. Open from May 20th to 
September 20th. The water contains iron, manganese, 
potassium chloride, and free carbonic acid. 

Allevard (Isere, France) is a carbonated sulphurous 
water containing calcium and magnesium bicarbonates, 
sodium chloride, calcium, sodium, and magnesium sul- 
phates, free sulphuretted hydrogen, carbonic acid, and 
nitrogen. The water may be imported and the season 
at the spring is from June ist to September ist. 

Apenta (near Budapesth) is an aperient water con- 
taining magnesium, sodium, and calcium sulphates, 
sodium chloride, with small quantites of lithium and 
potassium sulphates. It is imported. 

Apollinaris (Neuenahr, Germany) is a stable acidu- 

284 



MINERAL WATERS. 285 

lated alkaline water and contains sodium chloride, 
calcium and magnesium bicarbonates, with a large 
excess of carbonic acid. It is imported. 

Arabella (Hungary) is a saline aperient water used 
as a mild purgative and contains magnesium and 
sodium sulphates similar to Apenta. It is imported. 

Baden-Baden (Germany) is a lithiated arsenical 
water. The season at the springs is summer, and the 
water is imported. 

Bade?i (near Vienna) is a sulphurous water contain- 
ing calcium and sodium sulphates. It rises warm and 
has in it free carbonic acid. The place is open through- 
out the year. 

Bath (Somersetshire). — The only true thermal water 
in England. Saline, 21 grains in 20 oz. Chiefly 
calcium sulphate and small quantities of sodium sul- 
phate and magnesium chloride, with carbonic acid 
gas and nitrogen. Several baths varying in temper- 
ature from 88° to 120° F. (31. i° to 48.8 C). For 
chronic rheumatism, gout, and paralysis. The water 
is aerated and sold in bottles under the name of Sulis 
Water. Radium has been discovered in the waters of 
Bath and Buxton. 

Bethesda (Wisconsin, U. S. A.) is an alkaline water 
which is bottled for use. It contains calcium and 
magnesium bicarbonates. 

Buda-Pesth, St. Lucasbad (Hungary) is a warm sul- 
phurous water which contains potassium, sodium, and 
calcium sulphates and sulphuretted hydrogen. It is 
used for bathing (sulphur mud baths) and the hot 
water is taken internally. The place is frequented all 
the year. 

Buffalo Lithia (Mecklenburg Co., Va., U. S. A.) is 
an alkaline lithiated table water. There are three 
springs, of which No. 2 is the chief. The water con- 
tains calcium bicarbonate and sulphate, carbonic acid, 
and sulphuretted hydrogen. The place is open from 
June 15th to October 1st, or the water may be obtained 
bottled. 

Buxton (Derbyshire) is a slightly saline water con- 



286 MATERIA MEDICA FOR NURSES. 

taining sodium chloride, magnesium carbonate, cal- 
cium carbonate, free nitrogen, and carbonic acid. The 
place is open all the year round or the water may be 
bottled. 

Carlsbad (Bohemia) is a lithiated alkaline water from 
a number of springs practically all the same; that 
known as Sprudel is the most important. The water 
contains sodium bicarbonate, sulphate, and chloride, 
lithium and calcium bicarbonates, and carbonic acid. 
Season all the year round, principally in July. The 
water may be imported. Carlsbad Sprudel Salts (dry 
and crystals) are also supplied. 

Condillac (France) is an imported alkaline acidulated 
table water. 

Driburg (Westphalia) is a chalybeate, tonic, aperient 
water containing sodium sulphate, magnesium sul- 
phate, bicarbonate of calcium and magnesium, some 
iron and magnanese, and carbonic acid. Season from 
May ist to October ioth, or the water may be imported. 

Eaux Bonnes (Basses-Pyrenees, France) is a mild 
sulphurous water similar to Bareges and Cauterets. It 
contains sodium sulphate and chloride, calcium sul- 
phate, and sulphuretted hydrogen. Principal season 
from June ist to October ist, or the water may be 
imported. 

Ems-Bad (Germany) is an alkaline saline water that 
rises warm and contains sodium, calcium, and mag- 
nesium bicarbonates, sodium chloride, and free car- 
bonic acid. Season May ist to September 30th, or the 
water may be imported. 

Fontalis is a pure alkaline table water, aerated and 
bottled at Harrogate. It contains chlorides and 
carbonates free from lime and magnesium salts. 

Friedrichshall (Saxe-Meiningen, Germany) is an 
active diuretic and aperient water that is imported. It 
contains magnesium and sodium sulphates, sodium 
chloride, and magnesium chloride. 

Harrogate (Yorkshire) is a sulphurous water con- 
taining sodium sulphate, sodium, magnesium, and 
calcium chlorides, calcium carbonate, magnesium 



MINERAL WATERS. 2%J 

bromide, and sulphuretted hydrogen. It possesses 
aperient and diuretic properties. The season is sum- 
mer and winter or the water may be had in bottles. 

Hunyadi Janos (Buda-Pesth) is an imported aperi- 
ent water containing large percentages of magnesium 
and sodium sulphates, sodium chloride, and sodium 
and calcium bicarbonates. 

Kissingen (Bavaria, Germany), Rakoczy and Pauden 
springs, is a saline aperient water containing sodium 
and potassium chlorides, and iron and calcium 
bicarbonates. It is imported. 

Kissingen (Bavaria) Bitter Water is an aperient con- 
taining magnesium and sodium sulphates and carbonic 
acid. 

Leamington is a bottled saline water containing sod- 
ium, magnesium, and calcium sulphates, sodium, cal- 
cium, and magnesium chlorides, and ferrous carbonate. 

Malvern (Worcestershire) is a bottled water practi- 
cally free from saline matter, and contains no organic 
matter. 

Marienbad (Bohemia). There are several springs, 
alkaline, saline, chalybeate, and acidulated. The 
waters contain sodium sulphate, chloride, bicarbonates 
of alkaline earth metals, ferrous iron, and free carbonic 
acid. It is supplied in powder or crystals, and tablets 
are also made. The season is summer, or the water 
may be imported. 

Nauheim (Germany) is a chalybeate iron and lithia 
water used in skin and rheumatic affections and heart 
diseases. 

Nordhall (Lincolnshire) is a bromo-iodized water 
containing bromine, iodine, sodium chloride, and 
arsenic. The place is open from March 31st to 
October 31st. 

Salutaris is pure distilled water, still or aerated, for 
table use. 

Saratoga (U. S. A.) is an alkaline saline water from 
the " Congress" or " Hathorn " springs. It contains 
sodium chloride and iodide, bicarbonates of calcium 
and magnesium, and free carbonic acid. It is a mild 



288 MATERIA MEDICA FOR NURSES. 

aperient. The place is open all the year round, or the 
water may be obtained in bottles. 

Sellers, or Seltzer Water (on the Iyahn, Nassau), 
Ober and Nieder springs, is an alkaline acidulated 
table water containing sodium chloride, bicarbonates, 
and carbonic acid. It is imported. 

Spa (Belgium) is an imported ferruginous water 
containing ferrous bicarbonate and free carbonic acid. 
The season is summer. 

Sulis (Bath Water, aerated) is an aperient table 
water containing calcium and sodium sulphates, mag- 
nesium, and sodium chloride. 

Vichy (Allier, France) is an imported alkaline, acid- 
ulated water from one of the springs": Grande-Grille, 
Hopital, Celestins, or Pare. The place is open from 
May 15th to September 30th. 

Wiesbaden (Nassau) Kochbrunnen is an antacid 
water containing sodium and potassium chlorides, 
magnesium and sodium bicarbonates, and free car- 
bonic acid. The place is open all the summer or the 
water may be imported. 






SOLUTION TABLE. 









w 


H H 

w 

(L, fc 






USUAL 




H 


3 


•fi 


A.MT. 


DRUG. 


FORM. 


% 


So 


PER LITER. 


Boric Acid. 


Powder 


3 


i:33 


13.10 


4 tablespoonfuls 


Calcium Chloride. 


Masses 


2 


1:50 


8.75 


4 teaspoonfuls 


Carbolic Acid. 


Liquid 


5 


1:20 


21.90 


12 teaspoonfuls 


Mercuric Chloride 












(corrosive subli- 












mate). 


Crystals 


O.I 


1:1000 


0.44 


15 grains 


Creolin. 


Liquid 


2 


1:50 


8.75 


5 teaspoonfuls 


Lysol. 


Liquid 


2 


1:50 


8.75 


5 teaspoonfuls 


Potassium Per- 












manganate. 


Crystals 


0.4 


1:250 


1.75 


1 teaspoonful 


Solution of Hydro- 












gen Dioxide. 


Liquid 


25 


1:4 


109.00 


16 tablespoonfuls 


Solution of Normal 












Salt. 


Crystals 


0.9 


1:11 


3-95 


2 teaspoonfuls 


Thymol. 


Crystals 


.07 


1:1500 


0.30 


10 grains 


Zinc Chloride. 


Crystals 


2 


1:50 


8-75 


4 teaspoonfuls 



A teaspoonful is 60 grains, 1 drachm, or 4 grams, 
spoonful is 240 grains, 4 drachms, or 16 grams. 



A table- 



289 



RELATION OF MINIMS TO DROPS IN CER- 
TAIN MEDICINAL LIQUIDS. 



(SEE NOTE AT END.) 



Acetum Opii 


. tti, io = gtt. 15 


Acidum Aceticum 


. TT[ 10 = gtt. 18 




1 " Dilutum . 


. TT^ IO = gtt. IO 




' Carbolicum Liquefactum 


. TTl IO = gtt. l8 




' Hydrochloricum 


. V[ IO = gtt. IO 




' " Dilutum 


. TTL IO = gtt. IO 




' Hydrocyamcum " 


. TTJ, IO = gtt. IO 




1 Nitricum .... 


. TTL IO = gtt. 17 




1 " Dilutum . 


. TTL IO = gtt. IO 




' Nitrohydrochlor. Dilutum 


. TTL IO = gtt. IO 




' Phosphoricum 


. Til, IO = gtt. IO 




1 Sulphuricum Aromaticum 


. TTL IO = gtt. 24 




" Dilutum 


. TTj, IO = gtt. IO 


^ther Fortior .... 


. TTL IO = gtt. 30 


Alcohol 


. TTL IO = gtt. 24 


Amyl Nitrite 


. TTL IO = gtt. 30 


Aqua Ammoniae .... 


. TIT, IO = gtt. IO 


Chloroform 


. TTL IO = gtt. 40 


Copaiba 


. TTL IO = gtt. l8 


Creosotum 


. TTL IO = gtt. 20 


Kxtractum Acorriti Fluidum 


. TTL IO = gtt. 25 


" Belladonnse Fluidum 


. TTL IO = gtt. 25 


" Buchu " 


. TTL IO -gtt. 25 


" Ciuchonae " 


. til 10 = gtt. 20 


11 Colchici Sem. " 


. TTL IO = gtt. 25 


" Conii (Fructus) " 


. TTL IO = gtt. 20 


" Convallariae " 


. TTL IO = gtt. 25 


" Digitalis " 


. TTL IO = gtt. 20 




Krgotae " 


. TTL IO = gtt. 20 






290 



RELA TION OF MIMINS TO DROPS. 



291 



Extractum Gelsemii Fluidum . . . tti 10 = gtt. 25 

" Hyoscyami Fluidum . . . in, 10 = gtt. 25 

" Ipecacuanhas " . . . ttj, 10 = gtt. 20 

11 Nucis Vomicae " . . . tti 10 = gtt. 25 

" Pilocarpi " . . . v\, 10 = gtt. 20 

" Rhei " . , . ttj, 10 = gtt. 20 

" Scillae, U. S. (with alcohol), 

Fluidum v\ 10 = gtt. 20 

" Veratri Viridis Fluidum . . ttj, 10 = gtt. 25 

Liquor Acidi Arseniosi tti 10 = gtt. 10 

" Arsenii et Hydrargyri Iodidi . . tti 10 = gtt. 10 

" Ferri Chloridi Til 10 = gtt. 12 

" Ferri Nitratis til 10 = gtt. 10 

" Potassii Arseuitis . . . . tti, 10 = gtt. 10 

" Sodii Arseniatis . . . . tti 10 = gtt. 10 

Oleum Amygdalae Amarae . . . . ttj, 10 = gtt. 20 

" Anisi TTi 10 = gtt. 20 

Camphorae ( Japonicum) . . . m, 10 = gtt. 20 

" Caryophylli tti 10 = gtt. 20 

" Cinnamomi v\ 10 = gtt. 20 

" Copaibae ttj, 10 = gtt. 20 

" Fceniculi tti 10 = gtt. 20 

" Gaultheriae ttj, to = gtt. 20 

" Juniperi ttl 10 = gtt. 20 

" Menthae Piperitae . . . . ttl 10 = gtt. 20 

11 Phosphoratum tti, 10 = gtt. 15 

" Tiglii Ta 10 = gtt. 15 

Paraldehydum ttl 10 = gtt. 25 

Solutio Atropinae (not safe to trust to "drops") iU 10 = gtt. 10 

" Cocainae 1% " " " " " " tt\, 10 = gtt. 10 

" Strychninae " " " " " " tt[io = gtt. 10 

Spiritus Athens Compositus . . . tti, 10 = gtt. 25 

11 " Nitrosi . . . . Tq, 10 = gtt. 25 

" " Ammoniae Aromaticus . tti, 10 = gtt. 25 

" " Chloroformi . . . Tq, 10 = gtt. 25 

" " Glonoinii% . . . ttj, 10 = gtt. 25 

Tinctura Aconiti ttj, 10 = gtt. 25 

11 " Fleming's . . . . TU 10 = gtt. 25 

" Belladonnae ttl 10 = gtt. 25 



292 



MATERIA ME DIC A FOR NURSES. 






Tinctura Digitalis . 






. v\ 10 = gtt. 20 


" Ferri Chloridi 






. TTJ, IO = gtt. 25 


" Nucis Vomicae 






. m 10 = gtt. 25 


Opii 






. v\ 10 = gtt. 20 


" Opii Camphorata 






. Til IO = gtt. 20 


" Opii Deodorata 






. TF1, IO = gtt. 20 


" Stramonii 






. TTi IO = gtt. 20 


" Veratri Viridi 






. m 10 = gtt. 25 


Vinutn Colchici Radicis 






. 1^10 = gtt. 20 


" " Seminis 






. TTt IO = gtt. 20 


" Opii . 






. V{ IO = gtt. 18 



NOTE). — The ratio of drops to minims here given is only ap- 
proximate, and refers to drops as dropped from the edge of a 
bottle-neck of the style kept in the shops. It does not refer to 
drops such as are delivered from the fine point of an eye- or 
medicine-dropper. The sizes of the drops delivered by the 
latter are so varying that no reliable ratio to minims can be 
established. 

Chaexes Rice;. 

New York. 



NEWER REMEDIES AND PREPARATIONS 
FOR THE FOURTH REVISED EDITION. 

Acetal is a derivative of alcohol, employed as a seda- 
tive and hypnotic. It is usually given as an emulsion. 

Dose, 3 ij-iiss. (5-10 Gm.) 

Acetone (official) is prepared by the dry distillation 
of calcium acetate. It is a colorless liquid with a 
peculiar ethereal odor, and sharp, biting taste. Mis- 
cible with water, alcohol, and ether. Employed as a 
nervine, as an intestinal antiseptic and anthelmintic. 

Acetozone is a proprietary form of benzoyl-acetyl 
peroxide, and is used as an intestinal antiseptic and 
antipyretic. 

Airol (bismuth oxy-iodo-gallate), or dermatol oxi- 
dized with the addition of iodine, forms a greenish gray, 
fine, voluminous, inodorous, and tasteless powder. 
Moisture causes it to turn red with loss of iodine. 
Soluble in dilute acids and alkalies. Used as a dusting 
powder in place of iodoform. 

Albolene, a refined product of petroleum that cannot 
become rancid. Used as a basis for ointments. 
Albolene liquid is a colorless, odorless, tasteless fluid, 
very light and diffusible. Used as a solvent for drugs 
in oleaginous solution for sprays. 

Analgen is a remedy used as an anti neuralgic, anti- 
pyretic, and analgesic, and considered efficient. 

Dose, gr. x.-xv. (0.65-1 Gm.), repeated in three 
hours. 

Anesthol is an anaesthetic, composed of chloroform, 
ether, and ethyl chloride in the proportions respec- 
tively of 1, 2, 3, which corresponds closely to the A. C. 
K. mixture. 

Antinervin contains ammonium bromide, salicylic 

293 



294 MATERIA MEDIC A FOR NURSES. 

acid, and acetanilid. It is used as an anodyne and 
antineuralgic. 

Dose, gr. xv. (i Gm.) 

Apiol is a steroptene derived from garden parsley. 
Apioline is claimed to be the true active principle of 
parsley. Bach acts as a stimulating emmenagogue. 
Dose, m. iv.-viii. (0.2-0.4 Cc), in capsules at intervals 
of 3-6 hrs. for two days before the period of menstrua- 
tion. Continued use may bring on headache, giddi- 
ness, ringing in the ears, and mild intoxication. 

Apocodein hydrochloride is an amorphous yellowish 
powder used as an expectorant. Hypodermic dose, 
gr. i. (0.06 Gm.) 

Argyrol is a combination of silver with the yolk of 
eggs, containing 30 $ of silver. It is used as an 
antiseptic in inflammatory affections of the mucous 
membranes. Solution 5-20 %. 

Aristol (Annzdalzn). — The essential constituent of 
aristol is iodine, of which it contains about 45 $, other 
substances entering into its composition being thymol 
and sodium. It is odorless, and is used as a sub- 
stitute for iodoform. As an antiseptic it is not strong 
and has no poisonous qualities. It is used in dusting 
powders, ointments, and solutions in oil, ether, or 
collodion, usually in a strength of from 5-10 %. 

Asaprol has analgesic properties. It also checks 
hemorrhage, lowers temperature, and lessens nervous- 
ness and insomnia. It increases the amount of urine, 
and sometimes gives rise to profuse perspiration. In- 
ternally from gr. v.-xl. (0.3-2.65 Gm.) may be given 
in a day. It is soluble in water and in alcohol, and 
is incompatible with quinine, iodide of potassium, and 
the soluble sulphates. For lotions or irrigation it is 
prepared in a strength of 1-5 <f c . 

Aseptol is a compound made from sulphuric and 
carbolic acids. It is a reddish syrupy liquid used as 
an internal and external antiseptic. 

Asparagin is a derivative of marshmallow root and 
is also contained in asparagus. It is used as a diuretic. 
Dose, gr. ss.-i. (0.016-0.03 Gm.) 



NEWER REMEDIES AND PREPARATIONS. 295 

Atoxyl is an ami do-benzene compound of arsenic, 
administered in the form of a hypodermic in place of 
arsenic by mouth. 

Bebeerin, an alkaloid in the form of a white amor- 
phous powder with a bitter taste, used as a substitute 
for quinine. Dose, gr. i.-iss. (0.05-0.1 Gm.) 

Bensonaphthol \§ a. white, crystalline powder, used as 
an intestinal antiseptic, especially for children. Dose, 
gr. iv-viii. (0.25-0.5 Gm.) 

Benzosol is a compound of guaiacol. A colorless, 
inodorous, tasteless powder, insoluble in water. It 
contains about 50 <f of guaiacol. It is used as an 
antiseptic in the treatment of phthisis. 

Dose, gr. iv.-viii. (0.25-0.5 Gm.) 

Betol or Naphthalol is a compound analogous to salol, 
but containing 10 $ less of salicylic acid, and being 
correspondingly less active and less effective. In the 
intestines it decomposes into naphthol and salicylic acid. 
It is used in the same way as salol. It is best given in 
pill or emulsion. 

Dose, gr. ii.-v. (0.15-0.3 Gm.) 

Bismuton is a canary-yellow powder containing 
bismuth, resorcin, and tannin, used for intestinal 
catarrh and diarrhoea, especially in children. Dose, 
gr. viii-xv. (0.5-1. Gm.) 

Bismutose is a fine greenish yellow powder, with 
astringent taste, odorless and insoluble. It contains 
22 io bismuth in albumin and sodium chloride. Used 
as an antacid and antidiarrhoea remedy. It acts 
quicker than other bismuth compounds but is more 
constipating. Dose, gr. x-xx. (0.6-1.3 Gm.) 

B or 0- salicylate of Glycerin is a compound of boric 
and salicylic acids in concentrated form in which all 
their antiseptic and microbicide powers are retained, 
and is miscible with water in all proportions. Five 
Cc. of the compound contains 1 Gm. each of salicylic 
and boric acids. 

Bromal Hydrate is made by the action of bromine 
on alcohol. It is similar to chloral hydrate in its 
actions, being antispasmodic and hypnotic, but is 



296 



MATERIA MEDICA FOR NURSES. 



more powerful than chloral and more direct and dan- 
gerous in its influence over cardiac muscle. Large 
quantities may cause death, preceded by anaesthesia 
and convulsions. 

Dose, gr. ii.-v. (0.12-0.3 Gm.) 

Bromidia is said to contain potassium bromide and 
chloral-hydrate, of each 30 parts; extract of hyos- 
cyamus and extract of cannabis indica, of each 0.25 
parts ; fluid extract of liquorice, 90 parts; and oil of 
orange peel, 5 drops. 

Brominol, Bromipin, is a substitute for the bromides 
in the form of bromine 10 % in sesame oil, in which the 
properties of bromine are retained without any taste 
or odor of it or the resulting rash or depression after 
large doses. Dose 3 i.-iii. (4-12 Cc.) 

Bromocoll is a combination of bromine, tannin, and 
gelatin, containing 20 <f of bromine and used as a 
substitute for the bromides. 

Bromoformum (official) (Bromoform) is an ana- 
logue of chloroform, made from methylic alcohol and 
caustic potash. It is soluble in alcohol; only slightly 
so in water. It is quite powerful in its actions, which 
are antispasmodic, analgesic, and antiseptic. It has 
been used with success in whooping-cough. 

Dose, tfx i.-v. (0.06-0.30 Gm.) 

Cacodyl {Arsenic) Derivatives. — Cacodylic acid and 
sodium cacodylate and their combinations with 
mercury have been used extensively in anaemic and 
cachectic conditions, internally and as a lotion for the 
eyes or for sores elsewhere. Dose, gr. ss.-ii. (0.03-0. 13 
G-m.) hypodermically. 

Cetrarin is a bitter principle obtained from Iceland 
moss, and used as a stomachic. It increases peristalsis, 
likewise the secretion of saliva, bile, and pancreatic 
juice. Dose, gr. iss.-iii. (0.1-0.2 Gm.) 

Chaulmoogra Oil is a frothy substance obtained from 
seed of Gynocardia odorata ; used in the treatment of 
leprosy and tubercular conditions. Dose, ttl x-xxx. 
(0.6-2.0 Cc.) 

Chloralformamidum (official) is a preparation made 



NEWER REMEDIES AND PREPARATIONS. 297 

by the interaction of chloral and formamid, in the form 
of colorless crystals, employed as a substitute for 
chloral, being not so depressing as the latter, yet less 
certain in its hypnotic action. Dose, gr. xx.-xlv. 
(i-3 Gm.) 

Chloralose is a compound of chloral with grape sugar 
in the form of fine colorless crystals, with a bitter taste, 
freely soluble in hot liquids, but slightly so in cold 
water. It is used as a hypnotic, but is not so reliable 
as chloral. Dose, gr. iii.-viii. (0.2-0.5 Gm.) 

Chioretone is a compound formed by the action of 
caustic potash on equal parts of chloroform and 
acetone. It is used as an antiemetic in pregnancy, 
seasickness, and menstrual sickness, as a hypnotic and 
external antiseptic. Dose, gr. v.-xx. (0.3-1.3 Gm.) 

Condurango is the herb of Gonololus condurango, used 
as an alterative in syphilis and cancer. Dose of fluid 
extract, TTL 20-30. (1.2-2.0 Cc.) 

Cornutin is one of the active principles of ergot, a 
reddish to yellowish product (Kobert's) or white 
crystals (Keller's), used in place of ergot. Dose, gr. 
tV (0.005 Gm.) 

Coronilli7i is a glucoside from the seeds of Coronilla 
scorproides, forming a pale yellow, bitter powder, used 
to strengthen heart action and increase diuresis. Dose, 
gr. i.-iv. (0.06-.26 Gm.) 

Crede's Ointment contains 15 $ soluble metallic silver 
and is employed in septic inflammation and erysipelas. 

Creolin is an emulsion of cresol, a derivative of car- 
bolic acid. It mixes in all proportions with chloroform, 
ether, and alcohol, and with water forms a milky solu- 
tion. It is claimed that creolin is germicidal but not 
poisonous. It is used locally in a variety of ways: 
as an ointment, in a strength of 5 $; in solution, 1 $, 
or one half of one, for douches or vesical irrigation, 
etc. For surgical dressings creolin gauze is made in a 
strength of 5-10 </ . 

Chrysarobin is a principle obtained from goa powder 
found in the stems and branches of Andira arabolea, 
in the form of a light yellow crystalline powder, and 



298 MATERIA MEDICA FOR NURSES. 

is employed in the treatment of various skin diseases in 
an ointment of 10 %. 

Dermatol contains about 55 % of the oxide of bismuth. 
It is a yellow, odorless powder, insoluble. It is an 
excellent antiseptic, used in place of iodoform. It is 
also successfully used internally in some diseases of 
the alimentary canal. 

Dose, by mouth, gr. xxx. (2 Gm.) 

Locally it is used as a powder, in gauze, emulsion, 
or ointment. Strength, 10-20 <f . 

Diabetin is a trade name for lsevulose or fruit sugar. 

Dionin is the hydrochloride of a preparation of mor- 
phine, appearing in a fine white crystalline powder, 
possessing the narcotic properties of morphine without 
attaining its intensity. Toleration is not established 
by its use, hence it is used for the morphine habit. 
Its properties are similar to codeine. Dose, gr. J-J. 
(0.016-0.03 Gm.) 

Eosote, or creosote valerinate, is a non-caustic fluid 
used in tuberculosis and intestinal diseases as a dis- 
infectant. Dose, gr. iii. (0.2 Gm.) in capsules. 

Eucaine B may be used as a local anaesthetic in 
strength of \ of 1 % in place of cocaine, but is less 
satisfactory. It is irritant and must be used with care. 

Eudoxin is a bismuth salt of tetra - iodo - phenol- 
phthalein, containing 53 <f of iodine and 14.5 <f of 
bismuth, and used in stomachic and intestinal troubles 
in doses of gr. iii-viii. (0.2-0.5 Gm.) 

Eunatrol is sodium oleate in pill form, coated with 
chocolate and recommended as an excellent cholagogue 
in doses of gr. xv. (1 Gm.) twice daily. 

Euphthalmin is a synthetic alkaloid, being the hydro- 
chloride of the mandelic acid derivative of Bucaine B. 
It is a powerful mydriatic, its effect being short and 
without influence on the accommodation. It is used 
in 2 </o solution. 

Europhen is a powder containing about 27 % of iodine, 
and used as a substitute for iodoform. It is soluble in 
alcohol, ether, chloroform, and oil. As a dusting 
powder it is used in a strength of from 5-10, $ and 



NEWER REMEDIES AND PREPARATIONS. 299 

hypodermically solutions in olive oil are used in from 
3-10 <f strength. 

Ferratin. — This organic preparation of iron is made 
commercially by heating animal or vegetable albumin 
until the slimy consistency is lost, when an acid is 
added and a ferric compound of the albuminoids is 
formed. This after drying is readily soluble in alka- 
line solutions. It is absorbed more rapidly, and is less 
irritant than the inorganic preparations. Contains 7 % 
of iron. Dose, gr. viii.-xx. (0.5-1.5 Gm.) 

Glutolis formaldehyde gelatin, exhibited as a powder 
and used as an antiseptic. 

Hczmogallol is obtained by oxidizing the haemo- 
globin of the blood by the action of pyrogallol (a 
derivative of gallic acid). It is a reddish brown 
powder, easily assimilated, and is used in chlorosis 
and anaemia. It is insoluble in water, and is given in 
tablets or in wine. 

Dose, gr. iii.-viii. (0.2-0.5 Gm.) 

Hemoglobin is the red coloring matter of the blood 
corpuscles. It forms a red powder, soluble in water. 
It has been used in the treatment of anaemia and 
chlorosis. 

Dose, gr. iss.-iii. (0.09-0.18 Gm.) 

Helmitol is a compound of a preparation of citric 
acid and urotropin in the form of odorless and colorless 
crystals with a slightly acid taste, acting as diuretic 
and antiseptic. Dose, gr. v.-x. (0.3-0.6 Gm.) 

Hentol. — Obtained from haemoglobin by reduction 
with zinc dust. Contains 0.2 $ of iron. A number 
of combinations of hemol with other metals are in use, 
possessing the tonic properties of the former with 
the medicinal properties of the latter. Arsen-hemol 
contains 1 % of arsenous acid. Iodo-hemol contains 
16.6 ic of iodine. Zinc hemol contains 1 % of zinc. 

Holocain is obtained by uniting phenacetin and 
para-phenetidin in the form of insoluble crystals of 
bitter taste, and used as a local anaesthetic in ophthal- 
mology in solution of 1 $. 

Iodoformogen is an odorless compound of albumin 



300 MATERIA MEDIC A FOR NURSES. 

and iodoform. It is dry, impalpable, does not form 
lumps, and is three times lighter than iodoform, in 
place of which it is used. 

Iodothyrin is obtained from the thyroid gland of the 
sheep in the form of an amorphous brown powder, as 
a milk-sugar trituration; used as an alterative in doses 
of gr. xx.-xxx. (1-2 Gin.) daily. Contains 3 <f iodine. 

Jequirity is the seed of Abrus precatorius, the active 
principle of which is abrin or jequiritin, which is used 
as an irritant in chronic conjunctivitis. It is extremely 
poisonous. 

Kola contains the alkaloids theobromine and caf- 
feine, and a principle known as kolanin. It is used 
internally as an astringent. It lessens tissue waste, 
is a tonic stimulant to the circulation, and aids the 
alcoholic subject in resisting the craving for liquor. 

Lecithin is a phosphate obtained from the yolks of 
eggs, and is used in nervous affections. Dose, gr. iii -v. 
(0.2-0.3 Gm.) 

Listerine is an American specialty used as a lotion 
or mouth wash, and contains approximately boric acid 
25, benzoic acid 1, thymol 1, eucalyptol 1, oil of 
gaultheria 2, oil of peppermint \, tincture of baptista 
15, alcohol (90 <?o) 325, and water to make 1000. 

Litmus Paper for the testing of urine, etc., is colored 
blue by impregnation with a solution of litmus, which 
is a dye prepared from lichens with an alkali. Dipped 
into an acid the paper turns red, and the color is 
restored by an alkali. 

Loretin is a yellow, crj'stalline, odorless powder. It 
is considered a good antiseptic and deodorant. It is 
used as a dusting powder, also as an ointment, strength 
5-10 $; combined with collodion, strength, 2-10 $; 
and in pencils of cocoa butter, 5-10 $. 

Losophan is a preparation containing about 78 $ of 
iodine. It is used in powder, ointment, and solution, 
in from 10-20 $, in the treatment of skin diseases. 

Lysoform is a combination of lysol and formaldehyde 
used in solution of 5 to 10 $ as a disinfectant and 
antiseptic. 



NEWER REMEDIES AND PREPARATIONS. 301 

Lysol is a derivative of carbolic acid, containing 50 % 
of cresols. It forms a soapy liquid with water, and 
combines with alcohol and glycerin. It is used as a 
disinfectant for the skin, in 1 $ solution, and for 
wounds and abscesses in from 1-3 <f . 

Malakin is a mild antipyretic and anodyne. It acts 
slowly and gently, and has no unpleasant effect on the 
stomach. Neither does it produce cerebral symptoms. 
It sometimes, but not always, causes sweating. 

Dose, gr. xv.-lxv. (1.-4.3 Gm.) per day, in capsules. 

Marrubin or the glycerin extract of the red bone 
marrow may be used. Dose 3 i.-ii., increased if desired. 
This is recommended as a nutrient substitute for cod- 
liver oil. Being flavored it is palatable. It is cheap, 
and has had remarkably beneficial effects on weak 
children. It is easily assimilated and retained, and 
the effects are said to be quickly evident. 

Methacetin is a compound analogous to phenacetin. 
It is tasteless and colorless, soluble in alcohol, gly- 
cerin, and oil; also slightly soluble in water. It has 
been used as an antiseptic, analgesic, and antipyretic, 
and has been somewhat popular in the treatment of 
fevers in children. It is rather depressing, and has 
sometimes caused collapse. Large doses may bring on 
convulsions, followed by death. 

Dose, gr. ii.-v. (0.12-0.3 Gm.) 

Methylal is a local anaesthetic and hypnotic, derived 
from alcohol. It is soluble in water and alcohol, and 
has an aromatic odor and taste. The sleep produced 
by it is sound but of short duration. It is depressing 
in large doses. It has been used in cases of insanity 
and delirium tremens. 

Dose ttj, v. (0.3 Gm.), repeated once or twice. 



Methylthioninal Hydrochloridum, Methylthio- 
nine Hydrochloride— Methylene Blue (official)— is 
one of the "aniline dyes." It is slightly soluble in 
water. It is a bluish powder, and has been largely used 
in treating rheumatic and neuralgic disorders, and in 



302 MATERIA MEDICA FOR NURSES. 

phthisis and malaria. It is also considered a good anti- 
periodic. It is given in wafers or capsules, and hypo- 
dermically. It colors the urine blue or greenish blue. 

Dose, gr. iss.-viii. (0.09-0.52 Gm.) 

Migranin is an antipyrin preparation containing 
antipyrin, caffeine, and citric acid. It is used in the 
treatment of migraine and influenza. 

Dose, gr. xv. (1 Gm.) 

Nosophen is a yellow powder obtained by the action 
of iodine on phenol-phthalein, containing 60 $ of iodine 
and employed as an antiseptic dusting powder. 

Nuclein is a phosphorated proteid obtained from the 
spleen and other organs in the form of a pale yellow 
powder, soluble in alkaline solutions but insoluble in 
water and alcohol. It is said to increase the number 
of white blood cells and so destroy bacteria. Used in 
septicaemia, pneumonia, pleurisy, and tuberculosis. 
Dose, gr. v.-x. (0.3-0.6 Gm.) 

Orexin is a derivative of chinolin. It is a gray 
powder, of bitter taste, soluble in water and alcohol. 
It is used as an appetizer and stomachic tonic, but is 
somewhat irritating, and should not be given on an 
empty stomach. 

Dose, gr. iii. (0.2 Gm.), in capsule, at meal-time, or 
accompanied by food or some nourishing drink. 

Pellotine, an alkaloid obtained from a Mexican plant 
and used in the form of the hydrochloride as a hypnotic. 

Dose, gr. ^-i. (0.02-0.06 Gm.) 

Pental is a hydrocarbon obtained from fusel oil as 
a colorless liquid and used as a general and local anti- 
septic. It is depressing. 

Peronin is a hydrochloride of the benzyl ether of 
morphine, the action of which is between that of mor- 
phine and codeine. Dose, gr. \-\. (0.02-0.06 Gm.) 

Phenosalyl is a solution of carbolic, salicylic, and 
benzoic acids in lactic acid. It is used externally as 
an antiseptic, being considered superior to carbolic 
acid and less poisonous. It is a thick syrupy liquid, 
soluble in cold water in a strength of 7 $. It is used 
in solutions of 1 % and 2 <f . 






NEWER REMEDIES AND PREPARATIONS. 303 

Picric Acid. — Obtained by dissolving carbolic acid 
in sulphuric acid and to the compound formed adding 
nitric acid. It is a yellow, crystalline powder, soluble 
in water. Its action is antiseptic, astringent, and 
slightly irritant. Applied to suppurating burns through 
wet gauze it cleans and heals them readily. It should 
be applied thoroughly in all cases, the acid being 
removed frequently until the coagulated lymph covers 
the sore. It may also be applied to mucous membrane, 
in the form of a douche. It is sometimes rapidly 
absorbed and causes poisoning, the characteristic 
symptom being the yellow color of the skin, mucous 
membranes, and urine. Convulsions and collapse may 
occur. 

Piperazine is a drug formed by the action of ammonia 
upon ethylene bromide. It is used as a diuretic, its 
active properties arising from its capacity for dissolving 
uric acid. This solvent power is much greater than 
that of other drugs known. Gouty deposits are said to 
be neutralized and dissolved by piperazine. 

Dose gr. v.-x. (0.3-0.65 Gm.), in carbonated water. 

Protargol. — A silver compound containing 8.3 $ of 
metallic silver combined with protein. It is an anti- 
septic, slightly astringent, non-irritant, and absolutely 
free from all caustic or corrosive effects, even on the 
most sensitive membranes. It is used in \ to 40 $ 
solutions. It penetrates deeper into the tissues than 
other silver salts and should not be used for an in- 
definite length of time. It should be kept in amber 
vials. 

Pyramido7i is an amido derivative of antipyrin. It 
is milder, more gradual, and more lasting than 
antipyrin. Dose, gr. iii.-x. 

Pyrogallol. — Pyrogallic acid is obtained by the action 
of heat on gallic acid. It is used in skin diseases as a 
local irritant, caustic, and parasiticide. It stains the 
skin and clothing brown. It is generally employed in 
the form of ointment or in flexible collodion. It may 
cause poisoning, manifested by headache, diarrhoea, 
chills, vomiting, a reddish color to the skin, dark 



304 MATERIA MEDICA FOR NURSES. 

brown urine, rapid heart and respiration, restlessness, 
convulsions, coma, and death. 

Salipyrin. — This drug is the salicylate of antipyrin. 
It is considered an efficient antipyretic, and is also 
used in sciatica and rheumatism, influenza, and the 
dysmenorrhcea accompanying the menopause. 

Dose, gr. xv. (1 Gin.), and this may be repeated 
several times. 

Salophen is a derivative of salol, introduced as a sub- 
stitute for the latter in order to avoid effects arising 
from the liberation of phenol in the organism, which 
occurs when salol is used. Its physiological actions 
are similar to those of salol. 

Dose, gr. viii. (0.5 Gm.) 

Sanatogen is a combination of sodium - glycero- 
phosphate and casein, used as a nutrient tonic for 
children. 

Somatose is a preparation of meat in such a way as 
to be readily digestible, five parts of the preparation 
representing thirty parts of meat. Iron somatose and 
milk somatose are preparations with iron and from 
milk, respectively. 

Sontnal is made by the combination of chloral, alco- 
hol, and urethan. It is a colorless liquid which will 
not mix with cold water, but dissolves in alcohol or 
hot water. It is quite an efficient hypnotic, and 
usually prompt in its action. Its effects are considered 
less depressing than those of chloral, and more active 
than those of urethan. 

Dose, TT[ xv. -xxx. (1-2 Gm.), taken in syrup or 
whisky. 

Stypticin is obtained from narcotin, one of the alka- 
loids of opium, and may be used as a styptic in gyne- 
cological cases. It is given in solution, or in powder, 
wrapped in wafers, or best, in gelatine pearls. It may 
also be used hypodermically. 

Dose, gr. f-i. (0.025-0.06 Gm.), repeated frequently. 

Taka-diastase is a starch-digesting ferment obtained 
from fungus grown on wheat bran. Dose, gr. iii.-v. 
(0.2-0.3 Gm.) 






NEWER REMEDIES AND PREPARATIONS. 305 

Tannalbin is a red browu product made by com- 
bining tannin and albumin, and used as an intestinal 
astringent. Dose, gr. x.-xl. (0.6-3.6 Gm.) 

Terebenum (Terebene) is a colorless liquid, of hot 
taste, obtained by chemical process from oil of turpen- 
tine. It is used as a stimulant expectorant. 

Dose, gr. v.-xx. (0.3-1.3 Gm.), in an emulsion or 
in capsule. 

Terpini Hydras — Terpin Hydrate (official)— is 
made from turpentine and nitric acid. It is used as 
an expectorant in bronchitis, whooping-cough, and 
chronic nephritis. 

Dose, gr. iii.-vi. (0.2-0.4 Gm.), given in tablets or 
syrup. 

Terpinol is an oily liquid, obtained by combining 
terpine and hydrochloric acid. It has the same stimu- 
lant and expectorant properties as terpin hydrate, and 
is used under similar circumstances. 

Dose Tf[ x.-xv. (0.6-1. Gm.), given in capsule or 
pill. 

Tetronal is a compound allied to sulphonal, and in 
all points similar to trional. 

Dose, gr. x.-xx. (0.65-1.3 Gm.) 

Thallein acetate is a white crystalline salt used to 
check night sweats. Continued use causes baldness. 
Dose, gr. i.-iii, (0.06-0.2 Gm.) 

Theocin is a compound prepared artificially from 
acetic acid and is identical with theophilein. It has 
nearly double the diuretic activity of diuretin. Dose, 
gr. iii.-viii. (0.2-0.5 Gm.) 

Thymacetin is a derivative of thymol, and related to 
phenacetin. It is used as an analgesic and hypnotic 
in nervous cases. The after-effects are sometimes 
unpleasant. 

Dose, gr. iii.-xv. (0.25-1 Gm.) 

Trional is chemically allied to sulphonal, and is 
given as a hypnotic in nervous cases, and also as an 
antihydrotic in night sweats. When it is successfully 
given it produces a quiet sleep and a natural awaken- 
ing, but if, after being given twice in succession no 



306 MATERIA MEDICA FOR NURSES. 

results follow, it is useless to try it further. When it 
acts, it acts quickly, and sleep comes on within a short 
time. It should not be given for more than five or six 
nights in succession, as it sometimes causes prostration. 
It is apt to accumulate in the blood, and to avoid 
this, mineral waters are taken in conjunction with it. 
It causes constipation, and this must be watched for and 
overcome. It is given in hot milk just before retiring. 

Dose, gr. xv.-xxx. (1-2 Gm.) 

Tropococain is an alkaloid from a variety of coca, used 
like cocaine as a local anaesthetic. It is very costly. 

Tussol is anti-pyrinio-mandelate, and is used in 
whooping-cough. Dose, gr. f-vi. (0.05-0.4 Gm.) 

Urotropin. — Formed by the action of formaldehyde 
and ammonia. It is a valuable urinary antiseptic, 
sterlizing the urine by giving off some of its formalde- 
hyde. It increases the flow of urine and the excretion 
of uric acid, the solution of the urates beginning within 
twenty-four hours after the ingestion of the drug. It 
may be given in doses of 3 iss. (6 Gm.) daily, the 
single dose being gr. xv.-xx. (1.-1.5 Gm.). 

Veronal is a new hypnotic which is claimed to be 
superior to all others in simple insomnia. Its action is 
similar to that of trional, without the danger attending 
the use of the latter. It is twice as effective, may be 
increased in dose without danger, and leaves no un- 
pleasant after-effects. A small dose is often effective. 
It comes in the form of fine colorless and odorless crys- 
tals with a slightly bitter taste, soluble in 145 parts of 
water at 20 C. (68° F.) and in 12 parts of boiling 
water. Dose, gr. iv.-viii. (0.25-0.5 Gm.) 



INDEX 

Note. — The names of the drugs in the index which are set 
in italics belong to the Pharmacopoeia. The others are not 
official and are not found in the Eighth Decennial Revision 
of the United States Pharmacopeia. 



Absolute Alcohol . 


PAGE 
126 


Absorbents . 


4 


Absorption . 


4 


Aceta . 


9 


Acetal . 


293 


Acetanilide . 


154 


Acetanilidum 


J 54 


Incidental Effects 


*55 


Related Drugs . 


155 


Acetic Acid . 


109 


Dilute 


no 


Acetone . 


2 93 


Acetozone 


293 


Acetum 


. no 


Acids 




Acetic 


109 


Dilute 


no 


Arsenous . 


85 


Benzoic 


213 


Boric . 


108 


Carbolic {Phenol) 


143 


Citric 


in 


Dosage 


15 


Gallic 


XI 3 


Hydrochloric 


106 


Dilute 


107 


Hydrocyanic 


114 


Dilute 


. 114 


Lactic 


114 


Nitric 


105 


Dilute 


106 



Nitro-hydrochloric 


107 


Dilute 


107 


Oleic. 


158 


Oxalic 


117 


Phosphoric 


108 


Dilute 


108 


Salicylic 


i47 


Sulphuric . 


104 


Aromatic 


105 


Dilute 


105 


Sulphurous 


108 


Tannic 


112 


Tartaric 


112 


cidum 
Aceticum . 


109 


Dilutum . 


no 


Arsenosum 


85 


Benzoicum . 


213 


Boric um 


108 


Carbolicum 


!43 


Citricum . 


in 


Gallicum . 


IJ 3 


Hydrochloricum . 


106 


Dilutum . 


107 


Hydrocyanicum 


114 


Dilutum . 


114 


Lacticum . 


114 


Dilutum 


114 


Nitricum . 


105 


Dilutum . 


106 


Nitro-hydrochloricum 


107 



307 



3o8 



INDEX. 





PAGE 




PAGE 


Acidum — Continued. 




Agaricus 


256 


Nitro- hydro chloricun 


, 


Airol . 


293 


Dilutum 


IO7 


Albolene 


293 


Oleicum 


158 


Albuminous Bodies 


2 


Oxalicum . 


117 


Alcohol . 


Il8 


Phosphoricum . 

Dilutum . 


I08 


Absolute 


126 


I08 


Amyl, Amylicum 


119 


Salicylicum 


147 


Dilute, Dilutum . 


126 


Sulphuricum 


IO4 


Ethyl, Ethylicum 


119 


Aromaticum . 


I05 


Methyl, Methylicum . 


119 


Dilutum . 


I05 


Physiological Actions. 


I20 


Sulphurosum 


I08 


Preparations 


125 


Tannicum . 


112 


Symptoms of Poison- 




Tartaricum 


112 


ing . . 


!25 


Aconite . 


l6l 


Treatment of Poison- 




Fleming's Tincture o: 


164 


ing . 


125 


Fluidextract of . 


163 


Alcoholic Beverages 


126 


Liniment of 


164 


A Icoholic Extract of 




Physiological Actions 




Belladonna 


225 


22, 28 


, l6l 


Ale ... 


128 


Precautions 


163 


Alkali .... 


35 


Symptoms of Poison- 




Alkalies . . 3^ 


M 36 


ing 


l62 


Alkaline Gentian Mix-^ 




Tincture of 


164 


ture 


2 20 


Treatment of Poison- 




Alkaloids . . 2, i v 


h 35 


ing 


163 


of Aconite . 


164 


Aconitina 


164 


of Aloes 


248 


Aconitine 


164 


Aloes . . . . 


248 


Action of Drugs, Physio- 




Aloin . 


248 


> logical . . i 


*, 21 


Alteratives . . 4 


> 33 


Active Principles of 




Alum . . . . 


67 


Drugs 


2 


Dried 


68 


Adeps . 


259 


Physiological Actions. 


67 


Benzoinatus 


260 


Preparations 


67 


Lance 


260 


Symptoms of Poison- 




Praeparatus 


259 


ing . . 


67 


Adhesive Plaster . 


60 


Alumen 


67 


Adonidin 


166 


Exsiccatum 


68 


Adonis Vernalis 


166 


Alumeni Sulphas . 


67 


Infusion of 


166 


Aluminum Sulphate 


67 


Physiological Actions 


166 


Alumnol 


151 


Preparations 


166 


American Hellebore 


250 


Adrenalin 


282 


Ammonia . . 35 


, 49 


JEther (see Ether) . 


1 3 1 


Aromatic Spirit of 


5i 


^Ethylis Bromidum 


J 34 


Carbonate of 


5o 


ALthylis Chloridum 


135 


Chloride of 


5o 


Agaricin 


256 


Liniment . 


52 





INDEX. 


309 




PAGE 




PAGE 


Ammonia — Continued. 




Related Drugs . 


J 55 


Physiological Actions 


49 


Antigalactogogues 


30 


Preparations 


50 


Antihydropics 


4 


Salts of . . 36, 37 


Antikamnia . 


*55 


Symptoms of Poison- 




Antilithics 


4 


ing 


49 


Antimonii et Potassii 




Treatment of Poison- 




Tartras . 


86 


ing 


5° 


Antimonium 


86 


Water 


51 


Antimony 

and Potassium Tar- 


86 


Stronger . 


51 




Ammoniated Tincture 0) 




trate 


86 


Valerian 


210 


Symptoms of Poison- 




Ammoni, Bromidum 


95 


ing . . 


88 


Carbonas . 


5° 


Treatment of Poison- 




Chloridum . 


So 


ing 


88 


Ammonium . . 36, 37, 4Q 


Wine of 


88 


Bromide 


95 


Antinervine . . 155, 


293 


Carbonate . 37, 38, 50 


, 271 


Antiperiodics . 4 


33 


Chloride . .37, 38, 50 


Antiphlogistics 


32 


Hydroxide 


38 


Antiplague Serum . 


280 


Salts . 36, 37, 3 


8, 50 


Antipyretics . 5. 33» 


152 


Amygdala Amara . 


i94 


Antipyrina 


152 


Amygdalin . 


194 


Antipyrine 


!52 


Amylene Hydrate 


140 


Physiological Actions 


153 


Amyl Hydrate 


119 


Antiseptics . . 5 


. 34 


Amy lis Nitris 


140 


Antiseptin 


IOI 


Amyl Nitrite 


140 


Antiseptol 


IOI 


Anaesthetics . 


28 


Antisialogogues . 5 


, 24 


General 


28 


Antispasmodics . 5 


. 29 


Local 


28 


Antitoxins, 274, 277- 


-279 


Analeptics 


4 


Antityphoid Serum 


280 


Analgen 


293 


Antivenene . 


281 


Analgesics 


4, 28 


Antizymotics 


5 


Anesthol 


293 


Aperients . . 5 


. 25 


Anhidrotics . 


3 1 


Apiol .... 


294 


Animal Kingdom . 1 


,258 


Apocodeine Hydro- 




Anodynes 


4, 28 


chloride . 


294 


Antacids 


4 


Apomorphince Hydro- 




Anthelmintics 


4, 26 


chloridum 


178 


Antiarthritics 


4 


Apomorphine Hydro- 




Antidiphtheric Serum 


264 


chloride . .178, 


271 


Antidotes 




Apothecaries' Weight . 


18 


Acids 


266 


Approximate Equiva- 




Arsenic 


84 


lents 


19 


Antiemetics . 


25 


Aqua 




Antifebrine . 


154 


Ammonia . 


51 


Incidental Effects 


155 


Fortior . 


5i 



3io 


INDEX. 






PAGE 




PAGE 


A qua — Continued. 




Atropina 


. 225 


Camphorce . 


235 


Atropina Sulphas . 


. 225 


Creosoti 


147 


A tropina 


• 225 


Fortis 


I05 


Sulphate 


• 225 


Hydrogenii Dioxidi 


I03 


Auri Chloridum 


• 63 


Mentha Piperita 


2 33 


et Potassii Bromidum 


63 


Aquas . 


9 


et Sodii Chloridum 


. 62 


Argenti Nitras 


60 


Aurum . 


. 62 


Argenti Nitras Fusus 


62 






Argenti Nitras Mitigatus 


62 






Argentum 


60 


Balsam of Peru 


. 191 


Argol . 


38 


Balsam of Tolu 


. 192 


Argyrol 


294 


Balsamum Peruvianum 


. 191 


Aristol . . . 101, 


294 


Balsamum Tolutanum 


. 192 


Arnica . 


211 


Base 


• 35 


Aromatic Drugs 


2 


Basham's Mixture . 


• 7i 


Aromatic Powder . 


236 


Bebeerin 


• 295 


Aromatic Spirit of Am- 




Beer 


. 128 


monia 


51 


Belladonna, Leaves 


. 222 


Aromatic Sulphuric Acid 


105 


Extract 


• 225 


Aromatics 


2. 5 


Fluidextract 


. 225 


Arrow Poison 


221 


Physiological Action 


222 


Arseni 




Plaster 


. 225 


Iodidum 


85 


Poisoning . 


. 224 


Trioxidum . 82 


, 85 


Tincture 


. 225 


Arsenic .... 


82 


Benzanilid 


• i55 


Fowler's Solution of . 


85 


Benzoate of 




Iodide of . 


85 


Ammonium 


. 214 


Physiological Actions. 


82 


Lithium 


. 214 


Preparations 


85 


Sodium 


. 214 


Treatment of Poison- 




Benzoic Acid 


• 213 


ing 


84 


Benzoin 


213 


Trioxide . . 82 


. 85 


Benzoinated Lard . 


260 


White 


82 


Benzoinum . 


213 


Arsenium 


82 


Benzonaphthol . 151 


295 


Arsenous Acid . 82 


, 85 


Benzosal . .147 


295 


Solution of 


85 


Betanaphthol 


151 


Asafcetida 


201 


Betol . .151 


> 295 


Milk of . 
Pills of 


202 


Biniodide of Mercury 


79 


201 


Bismuth 


89 


Tincture of 


202 


Physiological Actions 


89 


Asaprol . .151, 


294 


Subnitrate of 


89 


Aseptol 


294 


Bismuthi Subnitras 


89 


Asparagin 


294 


Bismuthum . 


89 


Aspidium 


256 


Bismuton 


29S 


Astringents . . 5 


, 31 


Bismutose 


295 


Atoxyl . . 


295 


Bitter Almond 


194 



INDEX. 



311 



Bitter Principles 
Bitters . 

Aromatic . 

Simple 
Blackberry 
Black Draught 
Black Haw 
Black Snakeroot 
Black Wash . 
Bland's Pills . 
Blisters . 
Blue 

Gum Tree . 

Mass . 

Ointment . 

Vitriol 
Borax . 
Boric Acid 

Physiological Actions 

Ointment of 
Borosalicylate of Gly 

cerin 
Brandy . 
Brazilian Cocoa 
Brimstone 
Bromal Hydrate 
Bromide of Ether 
Bromides 

Ammonium 

Lithium 

Sodium 
Bromidia 
Bromine 

Incidental Effects of 

Physiological Actions 

Preparations 
Bromipin 
Bromocoll 
Bromoform 
Bromum 
Broom Tops 
Brucine 
Bucku . 
Burgundy 

Pitch . 

Plaster 

Wine . 



2 

2, 5 
2, 5 
2. 5 
i95 
194 
202 
236 
81 
72 

i75 

80 

80 

66 

48 

109 

109 

109 

295 

127 

181 

101 

2 95 

i34 

95 

95 

95 

95 

296 

94 

95 

94 

94 

296 

296 

296 

94 
190 
217 
186 

243 
243 
127 



PAGE 

Butyl Chloral Hydrate . 138 



Cacao Butter . 
Cachets 

Cacodyl (Arsenic) De- 
rivatives 
Caffeina 
Caffeine 
Calabar Bean 

Physiological Actions. 

Poisoning . 

Preparations 
Calcii Chloridum . 
Calcii Hypophosphis 
Calcium. . . 36, 

Chloride 

Hypophosphite . 

Oxide . . 52, 53 

Chlorinated 

Preparations 
Calefacients . 
California Buckthorn 
Calomel 
Calumba 

Fluidextract of . 

Tincture of 
Calx .... 

Chlorinata 
Camellia Thea 
Camphor 

Liniment 

Oil . 

Spirit of 

Water 
C amphora 
Camphorated Tincture of 

Opium . 
Cannabis Indica 
Cantharidal Collodion . 

Pitch Plaster 
Cantharides . 
Cantharis 
Capsicum 

Plaster . 
Carbo Animalis 
Carbo Ligni . 
Carbolic Acid (Phenol) . 



186 
12 

296 

208 

208 

192 

192 

192 

J 93 

55 

92 

52 

55 

94 

,54 

93 

53 

5 

189 

79 
167 
168 
168 
53 
93 
209 

234 
235 
236 

235 

235 
234 

i75 
241 
262 
262 
261 
261 
228 
228 
103 
103 
143 



312 


INDEX. 








PAGE 




PAGE 


Carbolic Acid — Continued. 


Cetrarin 


296 


Physiological Effects . 144 


Chalk Mixture 




54 


Symptoms of Poison- 


Chalk, Prepared 




54 


ing 


• I4S 


Champagne . 




128 


Treatment of Poison- 


Charcoal 




103 


ing 


• 145 


Charta . 




9 


Carbon . 


. IO3 


Chaulmoogra Oil 




296 


Compounds 


. Il8 


Chinolin 




151 


Carbonates . 


■ 35 


Tartras 




152 


Cardamom 


. 241 


Chloral . 




x 35 


Cardamomum 


. 241 


Camphor . 




138 


Cardiac 




Croton 




138 


Depressants 


5 


Hydrated . 




135 


Diuretics . 


5» 2 9 


Incidental Effects 


*37 


Sedatives . 


5. 22 


Physiological Actions 


i35 


Stimulants 


5. 21 


Symptoms of Poison- 




Tonics 


S» 21 


ing . 


136 


Carminatives 


. 25 


Treatment of Poison- 




Carron Oil 


• 54 


ing . . 


136 


Caryophyllus . 


• 197 


Chloralformamidum 


296 


Cascara Sagrada 


. 189 


Chloralose 


297 


Castor Oil 


. 238 


Chloralum Hydratum 


135 


Cathartics 


5, 25 


Chlorate of Potash . 


41 


Aperient . 
Cholagogue 


5. 25 


Chloretone 


297 


. 26 


Chloride of Ether . 


i35 


Drastic 


5. 26 


Chlorides 


35 


Hydragogue 


5, 26 


Chlorinated Calcium 




Laxative . 


5. 25 


Oxide 


93 


Saline 


5. 26 


Chlorinated Lime . 


93 


Simple 


. 26 


Chlorine 


92 


Cathartic Vegetable 


Pills. 198 


Chlorodyne . 


130 


Caustic Potash 


. 40 


Chloroform 


128 


Caustics 


6, 3 1 


Anaesthesia 


130 


Cayenne Pepper 


. 228 


Emulsion of 


130 


Cerata . 


9 


Liniment . 


130 


Cerate, Goulard's 


. 60 


Compound 


130 


of Lead Acetate 


. 60 


Physiological Actions . 


128 


Cerates . 


9, 11 


Spirit of 


130 


Ceratum Plumbi 


Sub- 


Symptoms of Poison- 




acetatis . 


. 60 


ing . 


129 


Cerebral 




Treatment of Poison- 




Depressants 


. 28 


ing . . 


129 


Stimulants 


• 27 


Chloroformum 


128 


Cerii Oxalis . 


■ 56 


Chlorum 


92 


Cerium . 


• 56 


Cholagogues . 


6 


Oxalate 


• 56 


Chrysarobin . 


297 


Cetaceum 


. 260 


Cimicifuga 




165 



INDEX. 



313 



Cimicifuga — Continued. 

Fluidextract of . 

Preparations 

Tincture of 
Cinchona 
Cinnamomum 
Cinnamon 
Circulatory System 
Citrate . . . 

of Magnesia, Solution 
Citric Acid 
Citrine Ointment . 
Claret . 
Classification of Reme 

dies 
Cloves . 
Coca 

Poisoning . 

Preparations 
Cocaines Hydrochloridum 
Cocaine Hydrochloride, 

183 
Codeina 
Codeine 
Cod Liver Oil 
Coffea Arabica 
Coffee Plant . 
Colchici Cormus 
Colchici Semen 
Colchicum 

Root . 

Seed . 

Physiological Actions 

Poisoning . 

Preparations 
Collapsubes . 
Collodion 

Flexible 

Styptic 

Vesicating . 
Collodium 

Cantharidum 

Flexile 

Stypticum . 
Colocynth 
Colocynthis . 
Combined Diuretics 



166 

166 

166 

202 

236 

236 

21 

35 

56 

in 

81 

127 



197 
181 
182 
183 
183 

274 
178 
178 
260 
208 
208 
252 
252 
252 
252 
252 
252 
253 
254 
12 

185 
185 
185 
185 
185 
185 
185 
185 
197 
197 
29 



PAGE 

Common Salt . .46 

Compound 

Cathartic Pills . .198 

Chloroform Liniment . 130 
Effervescent Powder . 48 
Extract of Colocynth . 198 
Fluidextract of Sar- 

saparilla . . .247 

Infusion of Senna . 193 
Iron Mixture . .72 

Licorice Powder . .191 

Morphine Powder . 177 
Spirit of Ether . . 133 

Syrup of Sarsaparilla . 247 
Syrup of Squill . 88, 247 
Tincture of Benzoin . 214 
Tincture of Gentian . 220 
Tincture of Lavender . 233 
Tincture of Opium . 176 
Condurango . . -297 

Confectio Sennce . . 193 

Confectiones ... 9 
Confections . . 9, 11 

Conine . . 199, 201 

Conium . . .199 

Physiological Action . 200 
Preparations . .201 

Symptoms of Poison- 
ing . . . 200 
Convallaria . . .248 
Convallarin . -249 
Convallarinum . -249 
Convulsants ... 6 
Copaiba . . .190 
Copper . . . -65 
Arsenite . . .86 
Preparations of . . 66 
Sulphate . . 66, 271 
Symptoms of Poison- 
ing . . .66 
Treatment of Poison- 
ing . . .66 
Cornutin . . . 297 
Coronillin . . -297 
Correctives ... 6 
Corrosive Mercuric Chlo- 
ride . . .77 



314 



INDEX. 



Corrosive Sublimate 


77 


Coto Bark 


237 


Cotoin . 


2 37 


Cotton, Gun- 


185 


Cotton-Wool . 


185 


Counter-irritants . 


h 3 1 


Cream of Tartar 


44 


Crede's Ointment . 


297 


Creolin . 


297 


Creosote 


146 


Water 


147 


Creosotum 


*47 


Creta Prceparata 


54 


Croton Chloral 


138 


Croton Oil 


2 37 


Cumulative Action 


3 


Cupii Arsenis 


86 


Cupri Sulphas 


66 


Cupric Sulphate 


66 


Cuprum 


65 



Dandelion . . .211 
Daturine . . .226 

Deadly Nightshade . 222 

Decocta ... 9 

Decoctions . . 9, 15 
Delphine . . .164 

Demulcents ... 6 
Deodorants . . 6, 34 

Deodorized Tincture of 

Opium . . . 175 

Depilatories ... 6 
Depresso-Motors . . 6 

Depurants ... 6 
Dermatol . . .298 

Desiccated Suprarenal 

Glands . . .264 
Desiccated Thyroid 

Glands . . .264 
Detergents ... 6 
Diabetin . . .298 
Diachylon Ointment . 60 
Dialyzed Iron . -74 

Diaphoretics. . 6, 31 

Digestive System . .24 
Digitaline . .232, 233 



Digitalis 

Fluidextract of . 

Incidental Effects 

Infusion of 

Physiological Actions 

Poisoning . 

Preparations 
Diluents 
Dilute, Acetic Acid 

Alcohol 

Hydrochloric Acid 

Hydrocyanic Acid 

Lactic Acid 

Nitric Acid 

Nitro-Hydrochloric 
Acid m . 

Phosphoric Acid 

Sulphuric Acid . 
Dionin . 
Diphtheria Antitoxin, 

264, 274 
Disinfectants 
Dispensatory 
Diuretics 
Diuretin 

D obeli's Solution 
Donovan's Solution 
Dosage . 
Dover's Powder 
Drastics 
Dried Alum . 
Drop Table . 
Drug . 
Drugs, Action of 

Active Principles 

Additional Notes 

Administration of 

Age in Relation to 

Albuminous Bodies 

Alkaloids . 

Cumulative Action 

Effects, Primary 
Secondary 

Food in Relation to 

Forms 

Glucosides . 

Gums 



229 
232 
231 
232 
229 
230 
232 
6 
no 
126 
107 
114 
114 
106 

107 
108 
105 
298 

278 
6, 34 
8 
6, 29 
. 150 
. 146 
. 86 

• IS 
. 176 
5. 26 
. 68 
. 290 

1 

• 2, 3 
2 

12 
^3. 14 
3. 13 
2 
2 
3 
4 
4 
4 
1 
2 
2 





INDEX. 


315 




PAGE 




PAGE 


Drugs, Action of — Continued. 


Saponis 


60 


Habit 


3 


Emulsa . 


9 


Hypodermics 


14 


Emulsions 


9 


Idiosyncrasy 


3 


Emulsum Chloroformi 


I30 


Liquid Preparations 


9 


Eosote . 


298 


Oils . % . 


2 


Epispastics . 


7. 3i 


Oleoresins . 


2 


Epsom Salt . 


55 


Physiological Actions 


1 


Ergot 


254 


Principles . 


2 


Ergotin 


255 


Aromatic 


2 


Errhines 


7 


Bitter . 


2 


Escharotics . 


7 


Odorous 


2 


Eserine . 


192 


Recent Methods oi 




Ether 


1 3 1 


Exhibiting 


12 


Bromide of 


134 


Resins 


2 


Chloride of 


135 


Sleep in Relation to 


4 


Compound Spirit of 


133 


Solid Preparations 


9, 11 


Physiological Actions 


132 


Source 


1, 2 


Preparations 


133 


Starches 


2 


Spirit of 


!33 


Sugars 


2 


Nitrous . 


1 33 


Toleration . 


3 


Ethyl, Bromide 


134 


Vegetable . 


1, 2 


Chloride 


135 


Dry Wines . .127 


128 


Hydrate 


119 


Duboisine 


3 2 


Oxide 


*3* 


Duotal 


147 


Eucaine B 


298 






Eucalyptol 


i95 


Ecbolics 


6, 3° 


Eucalyptus . 


J 95 


Effects of Drugs . 


4 


Eudoxin 


298 


Primary 


4 


Eunatrol 


298 


Secondary . 


4 


Eupatorium . 


211 


Effervescent Magnesiun 


, 


Euphthalmin 


298 


Sulphate 


56 


Europhen . .101 


298 


Elaterin . .198 


199 


Evacuants 


7 


Elaterinum . .198 


199 


Exalgine 


i57 


Elaterium . .198 


199 


Excitomotors 


7 


Elixiria . 


9 


Exodyne 


i55 


Elixirs . 


9 


Expectorants . 7, 2 


3- 24 


Emetics . . 6, 24 


, 270 


Extracta 


9 


Emetine 


208 


Extract of 




Emmenagogues 


6, 30 


Belladonna 


225 


Emmolients . 


7. 32 


Cascara Sagrada 


189 


Emplastra 


9 


Colocynih . 


197 


Emplastrum 




Convallaria 


248 


Adhcesivum 


60 


Nux Vomica 


219 


Belladonna 


225 


Opium 


J 74 


Capsici 


. 228 


Physostigmine . 


■ 193 


Plumbi 


. 60 


Senega 


. 181 



3i6 



INDEX, 





PAGE 




PAGE 


Extract of Stramonium. 


226 


Coca . 


. 183 


Extracts .. . 9, u, 15; 


Colchicum Seed 


• 254 


Extractum 




Conium 


. 20I 


Belladonna Foliorum 


225 


Convallaria 


• 249 


Colocynthidis 


I98 


Coto . 


• 237 


Compositus 


197 


Digitalis , 


. 232 


Convallariae . . 


249 


Ergot 


• 254 


Nucis Vomicae . 


219 


Eucalyptus 


. I96 


Opii . 


174 


Gelsemium 


. 2l6 


Physostigmatis . 


193 


Gentian 


. 220 


Rhamni Purshiance 


189 


Ginger 


. 241 


Senegae 


l8l 


Grindelia . 


. 212 


Stramonii . 


226 


Guar ana 


. l8l 


Eye 


32 


Hops 


. 242 






Hydrastis . 


. 167 






Hyoscyamus 


. 228 


Febrifuges 


7 


Indian Cannabis 


. 242 


Ferratin 


299 


Ipecac 


. 207 


Ferri et Potassii Tartrai 


* 73 


Lobelia 


. 213 


Ferri et Strychnince Ci- 




Lupulin 


• 243 


tras 


219 


Nux Vomica 


. 219 


Ferri Hydroxidum . 
Ferri Hydroxidum cum 


* 
73 


Phytolacca . 


. 249 




Pilocarpine 


- 188 


Magnesii Oxido 


74 


Podophyllum 


• • 165 


Ferri Hypophosphis 


92 


Quassia 


. 188 


Ferric Hydroxide . 


73 


Rubus 


• 195 


Ferric Hydroxide wit} 


1 


Rhubarb 


. 234 


Magnesium' Oxide 


74 


Sarsaparilla 


. 247 


Ferrum . 


68 


Senega 


. 121 


Reductum . 


72 


Senna 


• 194 


Filix Mas 


256 


Serpentaria 


• 236 


Filtration 


35 


Spigelia 


. 214 


Flaxseed 


183 


Squill 


. 247 


Poultice 


T84 


Stramonium 


. 226 


Tea . 


183 


Taraxacum 


. 211 


Fleming's Tincture oj 


E 


Valerian . 


. 2IO 


Aconite . 


. 164 


Veratrum . 


• 251 


Flexible Collodion . 


. 185 


Viburnum Pru 


nifo- 


Flowers of Sulphur 


. 102 


Hum 


. 202 


Fluidextract of 




Fluidextracta 


9 


Aconite 


. 163 


Fluidextracts 9 


10, 13, 15 


Belladonna Root 


. 225 


Fluidextractum 




Buchu 


. 186 


Aconiti 


. 163 


Calumba 


. 168 


Belladonnce Rad' 


'tis . 225 


Cascara Sagrada 


189 


Buchu 


. 186 


Cimicifuga 


. 166 


Calumba . 


. 168 


Cinchona . 


. 203 


Cannabis Indices 


. 242 





INDEX. 


317 




PAGE 




PAGE 


Fluidextractum — Continued. 


Gastric Sedatives . 


25 


Cimicifuga 


. 166 


Tonics 


25 


Cinchona . 


• 203 


Gaultherilene 


240 


Coca . 


. 183 


Gelsemium 


215 


Colchici Seminis 


• 254 


General 




Conii 


. 201 


Anaesthetics 


28 


Convallaria 


• 249 


Anodynes . 


28 


Coto 


• 237 


Generative Organs 


3° 


Digitalis 


. 232 


Gentian 


220 


Ergota ^ . 


• 254 


Gentiana 


220 


Eucalypti . 


. 196 


Gin 


127 


Gelsemii 


. 216 


Ginger . 


241 


Gentiana . 


. 220 


Glandula, Suprarenale* 




Grindelia . 


. 212 


Sicca 


264 


Guarana . 


. 181 


Thyroidea Sicca 


263 


Hydrastis . 


. 167 


Glonoin 


142 


Hyoscyami 


. 228 


Glucosides 


7 


Ipecacuanha 


. 207 


Glutol . 


299 


Lobelia 


• 213 


Glycerin 


158 


Lupulini . 


• 243 


Glycerinum . 


158 


Nucis Vomica . 


. 219 


Glycerita 


9 


Phytolacca 


• 249 


Glycerite of 




Pilocarpi . 


. 188 


Boroglycerin 


159 


Podophylli 


• 165 


Phenol 


J 59 


Quassia 


. 188 


Tannic Acid . 113 


x 59 


Rhamni Purshiana 


. 189 


Glycerites . . < 


?, 10 


Rhei . 


• 234 


Glyceritum 




Rubi . 


• J95 


Acidi Tannici . 113 


J 59 


Sarsaparilla 


. 247 


Boroglycerini 


i59 


Scilla 


• 247 


Phenolis 


159 


Senega 


. 181 


Glycerol . 


158 


Senna 


• i94 


Glycyrrhiza . 
Gold . 


191 


Serpentaria 


• 236 


62 


Spigelia 


. 214 


and Potassium Bro- 




Stramonii . 


. 226 


mide 


63 


Taraxaci . 


. 211 


and Sodium Chloride 


62 


Valeriana . 


. 210 


Chloride 


63 


Veratri 


• 251 


Preparations 


62 


Viburni Prunifolii 


. 202 


Golden Seal . 


166 


Zingiberis . 


. 241 


Physiological Actions 


167 


Formaline 


. 119 


Preparations 


167 


Fowler's Solution of A 


r- 


Gossypium Purificatum 


185 


senic 


• 85 


Goulard's Cerate 


60 


Friar's Balsam 


. 214 


Goulard's Extract 


60 






Grain Spirit . 


126 


Galactogogues 


7> 3° 


Granatum 


196 


Gallic Acid . 


• 113 


Griffith's Mixture . 


72 



318 



INDEX. 





PAGE I 




PAGE 


Grindelia 


212 


Hydrated Chloral . 


135 


Guarana 


181 


Hydrated Oxide of Iron . 


7i 


Guiacol . 


147 


Hydrochloric Acid . 


106 


Carbonate . 


147 


Hydrocyanic Acid 


114 


Salicylate . 


147 


Physiological Actions. 


115 


Salol . . 


x 47 


Symptoms of Poison- 




Guiacolis Carbonatis 


147 


ing . 


116 


Gums . 


2 


Treatment of Poison- 




Gun Cotton . 


241 


ing . 


116 


Gunjah . 


241 


Hydronaphthol 


151 






Hyoscine Hydrobromide . 


228 


Habit . 


3 


Hyoscyamine Sulphate . 


228 


Haematinics . 


33 


Hyoscyamus „ 


227 


Hasmogallol . 


299 


Hypnone 


139 


Haemoglobin . 


299 


Hypnotics . . 4, 7 


, 28 


Haemostatics 


6 


Hypodermics . 14, 


273 


Hashish 


241 


Hypophosphites . 


92 


Helmitol 


299 


Hysteria 


218 


Hemol . 


299 






Henbane 


227 


Ichthyol 


102 


Heroin . 


178 


Idiosyncrasy . 


3 


Hoffman's Anodyne 


133 


Indian Hemp 


241 


Holocain 


299 


Indian Poke . 


250 


Homatropince Hydrobro 




Indian Tobacco 


212 


midum 


• 225 


Infusa . 


9 


Homatropine Hyrdobro 




Infusion of 




mide 


• 225 


Adonis Vernalis 


166 


Hops . 


. 242 


Digitalis 


232 


Humulus 


. 242 


Senna 


194 


Huxham's Tincture 


• 203 


Infusions . . 9, 1 


3. 15 


Hydracetine . 


• 157 


Inhalations . .14 


, 24 


Hydragogues 


• 5 


Inorganic Acids 


104 


Hydrargyri 




Intestinal Antiseptics 


. 26 


Chloridum Corrosivun 


1 77 


Inunctions 


I 3 


Mite 


• 79 


Iodide of 




Iodidum Flavum 


• 79 


Arsenic 


85 


Rubruni . 


• 79 


Formyl 


99 


Oxidum Flavum 


79 


Potash 


97 


Hydrargyrum 


• 75 


Iodides . 


85 


Cum Creta. 


. 80 


Iodine . 


96 


Hydrastininoe Hydro 




Incidental Effects 


97 


chloridum 


. 167 


LugoVs Compound So- 




Hydrastinine Hydro 




lution of . 


98 


chloride . 


. 167 


Ointment . 


99 


Hydrastis . _ . 


. 166 


Physiological Actions. 


96 


Fluidextract of . 


. 167 


Preparations 


97 


Tincture of 


. 167 


Tincture of 


98 







INDEX. 


319 




PAGE 




PAGE 


Iodoform 


■ 99 


Lactic Acid . 


. 114 


Derivatives 




. IOI 


Dilute 


114 


Ointment . 




. IOO 


Lady Webster Pill . 


248 


Iodoformogen 




299 


Lamellae 


12 


lodoformum . 




99 


Lanolin 


258 


lodol 




IOO 


Laudanum 


175 


Iodolum 




IOO 


Laughing Gas 


52 


Iodophenine . 




157 


Laxatives 


5, 25 


Iodothyrin 




300 


Lead 


56 


Iodum . 




95 


Acetate 


59 


Ion Action 




36 


Physiological Actions 


56 


Ipecac . 




. 206 


Plaster 


60 


and Opium Powder 


176 


Poisoning . 


57 


Physiological Actions 


> 206 


Preparations 


59 


Preparations 


207 


Subacetate, Cerate of 


60 


Ipecacuanha . 


206 


271 


Solution of 


60 


Iron 




68 


Treatment of Poison- 




Absorption 




69 


ing 


59 


Administration 




70 


Lecithin 


300 


and Ammonia, Solu- 




Levant Wormseed . 


210 


tion of Acetate of 


7 1 


Licorice Root . 


191 


and Potassium Tar- 




Lily of the Valley . 


248 


trate 


73 


Lime ... 5 


2. 53 


and Strychnine Ci- 




Liniment . 


54 


trate 


219 


Milk of . 


54 


Dialyzed . 


74 


Preparations 


53 


Incidental Effects 


70 


Syrup of . 


54 


Mixture, Compound 


72 


Water 


53 


Physiological Actions 


68 


Liniment a 


9 


Pills of Aloes and 


73 


Liniment of 




Preparations 


70 


Aconite 


164 


Quevenne's 


72 


Ammonia . 


52 


Reduced 


72 


Calcium 


54 


Saline Combinations 


7° 


Camphor . 


234 


Irritants 


3 1 


Chloroform 
Chloroform, Com- 


130 


Jaborandi 


186 


pound 


130 


Jalap . 


220 


Soap . 


235 


Jalapin 
Jambul . 


220 


Liniments . . < 


). 11 


197 


Linimentum Aconiti 


164 


Jamestown Weed . 
Jequirity 


226 


Ammonias . 


52 


300 


Calcis 


54 


Juniper 


127 


Camphors . 


234 






Chloroformi 


130 


Kola . 


300 


Choroformi Composi- 








tum 


130 


Labarraque's Soluti 


on 


93 


Saponis 


235 



320 



INDEX. 



Linseed . 
Linum . 
Liquor Acidi Arsenosi 

Ammonii Acetatis 

Arseni et Hydrargyri 
Iodidi . 

Calcis 

Ferri et Ammonii Ace 
talis . 

Ferri Subsulphatis 
Tersulphatis . 

Formaldehydi 

Iodi Compositus . 

Magnesii Citratis 

Plumbi Subacetatis 

Potassii Arsenitis 
Hydroxidi 

Sodce Chlorinates 
Liquores 
Listerine 
Lithium 

Benzoate . 

Bromide 

Carbonate . 

Citrate 

Salicylate . 
Litmus Paper 
Liver of Sulphur . 
Lobelia . 
Local 

Anaesthetics 

Anodynes . 
Loretin . 

Losophan . . 101 
Lozenges 
LugoVs Compound Solu 

tion of Iodine . 
Lunar Caustic 
Lupulin 
Lupulinum . 
Lupulus 
Lycopodium . 
Lysoform 
Lysol . 



Madeira 



183 

183 

85 

Si 

86 
53 



7i 
72 
72 
119 
98 
56 
60 

85 
40 

93 

9 

300 

36, 48 

49 

95 

49 

49 

49 

300 

102 



28 

28 

300 

300 

9 

98 
62 

243 
243 
242 

257 
300 
301 



127 



PAGE 

Magendie's Solution of 

Morphine . .177 

Magnesia . . .55 

Physiological Actions . 5 5 

Preparations . -55 

Magnesii 

Oxidum . . .55 
Sulphas : . -55 
Effervescens . .56 
Magnesium . . .36 
Citrate, Solution of .56 
Oxide . . -55 

Sulphate . . -55 
Effervescent . .56 
Malakin . . .301 

Male Fern . . . 256 
Mandrake . . .165 
Manganese . . -74 
Physiological Actions. 74 
Preparations . -74 

Manganese Sulphate . 75 
Manganesium . -74 

Mangani Sulphas . -75 
Marrubin . . .301 

Massa Hydrargyri . . 80 
Materia Medica . . 1 

May Apple . . .165 
McMunn's Elixir . . 175 

Meadow Saffron . .252 
Medicine 1 

Menthol . . .233 

Mercurial Ointment . 80 
Mercury . -75, 275 
Biniodide of . -79 
Physiological Actions . 7 6 
Preparations . 77 

Protiodide of . -79 
Symptoms of Poison- 
ing ... 76 
Treatment of Poisoning 7 7 
with Chalk . . 80 
Metachloral . . .138 
Metals, The . . 12, 56 
Methacetine . . 157, 301 
Methylal . . .301 
Methylene Blue . .301 
Methyl Hydrate . .119 





INDEX. 


321 




PAGE 




PAGE 


Methylis Salicylis . 


147 


Motor Stimulants 


. 27 


Methyl Salicylate . 


149 


Mucilages 


9, IO 


Methylthioninal Hydro- 




Mucilagines . 


. 9 


chloridum 


30I 


Muriatic Acid 


. 106 


Methylthionine Hydro- 




Mustard 


179. 270 


chloride . 


3OI 


Physiological Ac 


tions. 179 


Metric System 


16 


Mydriatics 


7> 32 


Micro cidin 


151 


Myotics 


7. 32 


Migranin . . 


302 


Myrrh . 


. 189 


Mild Mercurous Chloride 


79 


Myrrha . 


. 189 


Milk of Asajcetida . 


201 






Milk of Lime 


54 


Naphthalene . 


• 151 


Mineral Waters 


284 


Naphthalenum 


• 151 


Mistura 




Naphthalol . 


• 295 


Ammoniaci 


51 


Naphthol 


• 151 


Asafcetidae 


202 


Narcotics 


7, 28 


Cretce 


54 


Natural Orders, A 


myri- 


Ferri Composita 


72 


daceae 


. 189 


Gentianas Alkalina 


220 


Apocynaceae 


. 221 


Misturas 


9 


Aristolochiae 


• 236 


Mitigated Caustic . 


62 


Byttneriaceae 


. 186 


Mitigated Silver Nitrate . 


62 


Caprifoliaceae 


. 202 


Mixture of 




Compositas. 


210, 256 


Alkaline, Gentian 


220 


Coniferae . 


• 243 


Ammonia . 


51 


Convolvulaceae 


. 220 


Asafcetida . 


202 


Cruciferae . 


• !79 


Chalk 


53 


Cucurbit aceae 


• J 97 


Iron, Compound 


72 


Erythroxylaceae 


. 181 


Mixtures . . g 


» 10 


Euphorbiaceae 


• 237 


Monk's Hood 


161 


Filices 


. 256 


Monsel's Solution . 


72 


Fungi 


• 256 


Morphina 


176 


Gentianaceas 


. 220 


Morphines 


176 


Graminaceas 


• 254 


Ac etas 


176 


Labiatae 


233. 248 


Compositus, Pulvis 


177 


Lauracese . 


• 234 


Hydrochloridum . 


176 


Leguminosae 


. 189 


Sulphas 


177 


Liliaceae 


. 246 


Tinctura Chloroformi 




Linaceae 


• 183 


et . 


177 


Lobeliaceae 


. 212 


Morphine . .176, 


274 


Loganiaceae 


. 214 


Acetate . . » 


176 


Lycopodiaceas 


• 257 


Hydrochloride 


176 


Malvaceae . 


• 185 


Powder, Compound 


177 


Melanthaceas 


. 250 


Sulphate 


177 


Menispermaceas 


. 167 


Tincture of Chloro- 




Myrtaceae . 


• i95 


form and 


177 


Oleaceae 


. 214 


Motor Depressants 


27 


Paponeraceae 


. 169 



322 




INDEX. 








PAGE 






PAGE 


Natural Orders — Cont. 




Odorous Principles 




2 


Phytolaccaceae . 


249 


Oil of 






Polygalaceae 




l8o 


Betula 


. 


24O 


Polygonaceae 




234 


Camphor . 


. 


236 


Ranunculaceae 




l6l 


Cod-Liver . 




260 


Rharnnaceas 




189 


Eucalyptus 




I96 


Rosaceae . 




194 


Gaultheria 


. 150. 


24O 


Rubiaceae . 




202 


Juniper 




245 


Rutaceae . 




186 


Lavender Flower 


s 


2 33 


Salicaceae . 




24O 


Olive . 




214 


Sapindaceag 




l8l 


Peppermint 


, e 


233 


Scrophulariaceae 




229 


Rue . 


, . 


186 


Simarubaceae 




188 


Savin 




245 


Solanaceae . 




222 


Sweet Birch 




240 


Styracaceae 




213 


Tar . 


, 


243 


Ternstromiaceae 




209 


Theobroma 


, 


186 


Umbelliferae 




199 


Turpentine 


, 


243 


Urticaceae . 




242 


Vitriol 


, 


104 


Valerianaceae 




209 


Wintergreen 


. 


240 


Zingiberaceae 




241 


Oils 


, , 


2 


Nervous System 




27 


Ointment of 






Neurotics 




7 


Belladonna 


, 


225 


Nicotine 




229 


Boric Acid 


, 


109 


Nitrate of Silver 




60 


Chrysarobin 




297 


Nitric Acid . 




105 


Diachylon . 




60 


Dilute 




106 


Mercury 


. 


80 


Physiological Actions . 


106 


Nitrate . 




81 


Poisoning and Anti- 




Red Oxide of Met 


cury . 


81 


dotes 


106 


Yellow Oxide of 


Mer- 




Preparations 


106 


cury . 




81 


Nitroglycerin 


142 


Veratrine . 


. 


252 


Nitroglycerinum . 


142 


Ointments 


, 


9 


Niirohydrochloric Acid . 


107 


Oleata . 


, 


9 


Nitrous Oxide Gas 


52 


Oleate of 






Non-Metallic Elements . 


89 


Atropine . 


158, 


225 


Norwood's Tincture 


251 


Cocaine 


158, 


183 


Nosophen 


302 


Mercury . 


80, 


158 


Nuclein 


302 


Quinine 


158, 


203 


Nutriants 


7 


Veratrine . 


158, 


252 


Nutrients 


7 


Oleates . 


9 


, 10 


Nux Vomica . 


217 


Oleatum 






Extract 


219 


Atropines . 


158, 


225 


Fluidextract 


219 


Cocaince 


158, 


183 


Physiological Actions 


217 


Hydrargyri 


80, 


158 


Preparations 


219 


Quinines 


158, 


203 


Sympt. of Poisoning 


217 


Veratrince . 




252 


Tincture 




219 


Oleic Acid 


. 


158 







INDEX. 


323 




PAGE 




PAGE 


Oleoresinse 


9 


Paraldehydum 


138 


Oleoresins . . 2, 9 


, IO 


Parasiticides . 


34 


Oleum 




Paregoric 


175 


BetulcB 


240 


Paris Green . 


86 


Camphorae 


236 


Pellet ierine Tannate 


197 


Eucalypti . 


195 


Pellitory 


256 


Gaultheria . . 150, 


24O 


Pellotine 


302 


Juniperi 
Lavandula Florum 


245 


Pental . 


302 


233 


Pepo 


199 


Mentha Piperita 


233 


Pepper . 


228 


Morrhuce . 


260 


Peppermint . 


233 


Oliva 




214 


Camphor . 


233 


Picis Liquida 




243 


Pepsin . 


258 


Ricini 




238 


Pepsinum 


258 


Sabince 




24S 


Peronin 


302 


Terebinthina 




243 


Peroxide of Hydrogen 


103 


Theobromatis 




186 


Peruvian Bark 


202 


Tiglii 




237 


Petrolatum 


158 


Olive Oil 




214 


Pharmacopoeia 


8 


Opium . 




169 


Phenacetine . 


156 


Camphorated Tincture 


175 


Phenocoll Hydro 




Compound Tincture . 


176 


chloride . 


157 


Extract 


J 74 


Phenol . 


J 43 


Incidental Effects of . 


J 74 


Phenolid 


155 


Physiological Actions. 


169 


Pheno-Resorcin 


156 


Pills of 


174 


Phenosalyl . 


302 


Powder, Ipecac and 


176 


Phenylis Salicylas 


149 


Preparations 


174 


Phenyl Salicylate . 


149 


Symptoms of Poison- 




Phosphates . 


36 


ing 


171 


Phosphoric Acid 


108 


Tincture of 


175 


Dilute 


108 


Ipecac and 


176 


Phosphorus . 


89 


Treatment of Poison- 




Physiological Action 


90 


, ing . 


172 


Pills of 


92 


Orexin . 


302 


Preparations 


92 


Organic Acids 


109 


Treatment of Poison- 




Iron . 


268 


ing 


9i 


Materia Medica . 


161 


Physostigma . 


192 


Osmosis 


46 


Physostigmine 


192 


Oxalic Acid . 


117 


Extract 


193 


Oxide of Zinc 


65 


Sulphate 


193 


Oxytocics 


7 


Tincture 


193 






Phytolacca 


249 






Picric Acid . 


3°3 


Pancreatin 


259 


Picrotoxin 


168 


Papers <; 


, 11 


Picrotoxinum 


168 


Paraldehyde . 




138 


Pills . 


9 , 11 



324 



INDEX. 



Pills of 

Aloes and Iron . 

Aloes and Mastic 

Asafcetida , 

Compound Carthartic 

Ferrous Carbonate 

Ferrous Iodide . 

Opium 

Phosphorus 

Vegetable Carthatic 
Pilocarpines Hydro- 

chloridum 
Pilocarpine Hydro- 

chloride . 
Pilocarpus 
Pilulas . 

Aloes et Ferri 

Aloes et Mastiches 

Asaf&tidce . 

Cartharticce Composites 

Cathartics Vegetabilis 

Ferri Carbonatis 

Ferri Iodidi 

Opii . 

Phosphori 
Pink Root 
Piperazine 
Pictures 
Pix Liquida 
Plasters 
Plumbi Ac etas 
Plumbum 
Podophyllum 
Poison Nut 
Poisons 
Poke . 

Pomegranate Rind 
Porter . 
Port Wine 
Potash . 

Potassa Sulphurata 
Potassii 

Ac etas 

Bicarbonas 

Bitartras 

Bromidum 

Carbonas 



73 
248 
201 
198 

72 

73 

i74 

92 



185 
186 

9 

73 
248 
201 
198 
198 

72 

73 
i74 

92 
214 
303 
275 
243 
9, 11 

59 
56 
165 
216 
265 
249 
196 
127 
127 
38 
102 

41 
39 
44 
94 
39 



Chloras 

Citras 

Cyanidum . 

et Sodii Tartras 

Hydroxidum 

Hypophosphis 

Iodidum 

Nitras 

Permanganas 
Potassium 

Acetate 

Action of . 

and Sodium Tartrate 

Bicarbonate 

Bitartrate . 

Bromide 

Carbonate . 

Chlorate 

Chloride 

Citrate 

Cyanide 

Hydroxide . 

Hypophosphite 

Iodide 

Nitrate 

Permanganate 

Poisoning by- 
Preparations 

Treatment of I 
ing 
Potato Spirit 
Powdered Ipecac 
Powders 
Prepared Chalk 
Prepared Lard 
Proof Spirit . 
Propenyl Alcohol 
Prophylactics 
Protargol 
Protectives . 
Protiodide of Mercury 
Prunus Virginiana 
Prussic Acid . 
Pulmonary Sedatives 
Pulveres 
Pulvis 

Aromaticus 



38 



37. 



41 
41 
43 
45 
40 
92 
97 
43 
74 
36-38 
41 
38 
45 
39 
44 
94 
39 
41 
37 
41 
43 
40 
02 
97 
44 
74 
38 
39 

39 
119 
207 
» n 

54 
259 
126 

158 
7 

303 
32 
79 

i95 

114 

23 
9 

236 



INDEX. 



325 



PAGE 

Pulvis — Continued. 

Effervescens Compo situs 48 
Glycyrrhiza Compo si tus 191 
Ipecacuanha . .207 

Ipecacuanha et Opii . 176 
Jalapce Compo situs . 220 

_ Morphince Compositus 177 



Pumpkin Seeds 


• i99 


Purgatives . 5, 


25. 26, 37 


Purple Foxglove 


. 229 


Pustulents 


• 3 1 


Pyramidon . 


• 303 


Pyrethrum 


. 256 


Pyridine 


• iS7 


Pyrogallol 


■ 303 


Pyroxilinum . 


. 142 


Quaker Buttons 


. 216 


Quassia 


. 188 


Fluidextract of 


. 188 


Tincture of 


. 188 


Quevenne' s Iron 


• 72 


Quicksilver 


• 75 


Quinine . 


. 203 


Quinines Sulphas 


. 204 


Quinina 


• 203 


Incidental Effecl 


,s . 205 


Physiological Ac 


tions. 204 


Sulphate . 


• 205 


Rabies Antitoxin 


• 279 


Radiology 


• 283 


Raspail's Sedative 


Water 52 


Rectified Oil of Tt 


irpen- 


tine 


• 245 


Rectified Spirit 


. 127 


Red Iodide of Merc 


:ury . 81 


Reduced Iron 


. 72 


Red Wine 


. 127 


Refrigerants . 


7, 24 


Renal Diuretics 


. 29 


Resina Podophylli 


• 165 


Resinae . 


9 


Resins . 


. 2, 9, 11 


Resorcinol 


• i55 


Respiratory Depre 


ssants 23 


Stimulants 


• 23 


System 


• 2 3 



Restoratives . 

Revulsants . 

Rhamnus Purshiana 

Rheum . 

Rhubarb 

Rhus Toxicodendron 

Rochelle Salt . 

Rubefacients. 

Rubus . 

Rue 

Rum 

Ruta Graveolens 



Sabina . 

Saccharin 

Saccharum Lactis 

Sacred Bark . 

Saleratus 

Salicin . 

Salicinum 

Salicylic Acid 

Saline Purgatives 

Salines . 

Salipyrin 

Salol . 

Salophen 

Salt 
Epsom- 
Glauber's . 
Rochelle 

Salt Action . 

Saltpetre 

Salts 

Sanatogen 

vSanitas . 

Santonica 

Santonin 

Saponin 

Sarsaparilla . 

Sar saponin . 

Saturated Solution 

Savin 

Scammonium 

Scammony 

S cilia 

Scoparius 

Sea-Onion 



33 

7 

189 

234 
234 
59 
45 
1 3i 
i95 
186 
127 
186 



• 245 

• i57 

• 258 
. 189 

• 39 
150, 240 
150, 240 

• 147 
. 26 

5. 37 

• 304 

• i49 

• 3°4 
271, 274 

36, 55 

• 36 

• 45 

• 36 
. 44 

• 13 

• 304 
. 245 
. 210 
. 210 

• 247 

• 247 

• 247 

• 13 
. 245 
. 220 
. 220 
. 246 
. 190 
. 246 



326 



INDEX, 



Seidlitz Powder 


PAGE 
• 48 


Chloride 


PAGE 

37» 46 


Sedatives 


8 


Hydroxide . 


37. 45 


Senega . 


. 180 


Hypophosphite 


. 92 


Senna . 


• 193 


Salicylate . 


. 149 


Confection of 


• 194 


Solubes 


12 


Fluidextract of 


• 194 


Solution Table 


. 289 


Syrup of . 


• 194 


Solution of 




Sera 


• 2 77 


Ammonium Acetate . 51 


Serpentaria . 


• 236 


Arsenous Acid 


• 85 


Serum 




Arsenous and 


Mer- 


A ntidiphthericun 


* . 264 


curie Chloride 


. 86 


Therapy- 


. 276 


Chlorinated Soda 


. 93 


Sherry . 


. 127 


Ferric Subsulphate . 72 


Sialogogues . 


. 24 


Sulphate 


• 72 


Silver . 


. 60 


Formaldehyde 


. 119 


Nitrate 


. 60 


Hydrogen Dioxide . 103 


Fused 


. 62 


Iron and Ammonium 


Mitigated 


. 62 


Acetate . 


• 71 


Physiological Ac 


tions. 61 


Lead Subacetate 


. 60 


Symptoms of Poi 


soning 61 


Magnesium Citrate . 56 


Simple Purgatives 


• 25 


Potassium Arsenite . 85 


Simple Syrup 


10 


Hydroxide 


. 40 


Sinapis . 


• 179 


Solution Table 


. 289 


Skin 


• 3 1 


Solutions 


9, 10 


Snake-Root . 


180, 236 


Somatose 


• 3°4 


Soap Liniment 


• 235 


Somnal . 


• 304 


Plaster 


. 60 


Somnifacients 


. 8 


Suds . 


. 271 


Soporifics 


. 28 


Soda 


• 45 


Sorbefacients 


. 8 


Physiological Ac 


tions. 46 


Sozal 


. IOI 


Sources 


• 45 


Sozoidal 


. IOI 


Sodii 




Spanish Flies 


. 261 


Bicarbonas 


• 47 


Sparteine Sulphate 


. 190 


Boras 


• 48 


Specifics 


8 


Bromidum . 


• 95 


Spermaceti 


. 260 


Carbonas . 


• 47 


Spigelia 


. 214 


Chloridum . 


. 46 


Spinal Depressants 


. 27 


Hydroxidum 


• 45 


Spinal Stimulants . 


. 27 


Hypophosphis 


. 92 


Spirit of 




Salicylas . 


• 149 


Camphor . 


• 235 


Sodio-Theobromine 


Sali- 


Chloroform 


. 130 


cylate 


. 150 


Ether 


• 133 


Sodium . 


• 36 


Glyceril Nitrate . 


. 142 


Bicarbonate 


• 47 


Lavender . 


• 233 


Borate 


. 48 


Mindererus 


• 5 1 


Bromide 


• 95 


Nitroglycerin 


. 142 


Carbonate . 


37» 47 


Nitrous Ether 


• 133 





INDEX. 


327 




PAGE 




PAGE 


Spirits . . .9, 


to, 15 


Sulphaminol . 


. IOI 


Spiritus 


9 


Sulphates 


• 36 


ALtheris 


• 133 


Sulphonal 


• 139 


Compositus 


• 133 


Sulphur 


. IOI 


Nitrosi . 


• 133 


Liver of 


. I02 


Ammonia Aromaticus 


51 


Lotion 


. I02 


Camphora . 


• 235 


Ointment . 


. I02 


Chloroformi 


- 13° 


Sublimatum 


. I02 


Frumenti . 


. 126 


Sulphuric Acid 


. IO4 


Glycerilis Nitratis 


142 


Aromatic . 


. I05 


Lavandula 


2 33 


Dilute 


I05 


Rectificatus 


127 


Physiological Actions 


. IO4 


Tenuior 


126 


Poisoning . 


. IO4 


Vini Gallict 


126 


Sulphurous Acid . 


. I08 


Spotted Hemlock 


• 199 


Suppositoria . 


9 


Squibb's Mixture . 


176 


Suppositories 


9, 12 


Squill . . .24^ 


, 247 


Suprarenal Gland . 


. 281 


Squirting Cucumber 


198 


Sweet Spirit of Nitre 


1 33 


Staphisagria . 


165 


Sweet Wines . 


128 


Starches 


2 


Syrupi . 


9 


Stavesacre 


164 


Syrup of 

Calcium Hydroxide 




Sterules 


12 


54 


Stimulants 


8 


Ferrous Iodide . 


7 1 


Stomachics . 


8 


Hypophosphites . 


92 


Stomach-tube 


270 


Ipecac 


207 


Stout 


127 


Iron, Quinine, ana 




Stramonium . 


226 


Strychnine Phos- 




Strophanthin . 


221 


phate 


219 


Strophanthus 


221 


Lime . 


54 


Strychnine . .217 
Precautions 


274 


Rhubarb 


234 


218 


Sarsaparilla, Com- 




Preparations 


219 


pound 


247 


Sulphate 


219 


Senega 


181 


Syrup of Phosphate oi 




Senna 


194 


Iron, Quinine, and 


219 


Squill 


247 


Treatment of Poison- 




Tar . 


2 43 


ing 


218 


Syrups . . . 9, 10, 15 


Styptic Collodion . 


185 


Syrupus 
Calcis 




Stypticin 


304 


54 


Styptics 


32 


Ferri lodidi 


7 1 


Styracol 


147 


Ferri, Quinines, e 


I 


Sublimed Sulphur . 


102 


Strychnines Phos- 




Subnitrate of Bismuth 


89 


phatum 


219 


Sudorincs 


8 


Hypoph osphitum 


92 


Sugar of Lead 


59 


Ipecacuanha 


207 


Sugar of Milk 


258 


Rhei . 


234 


Sugars . 


2 


Rubi . 


195 



328 


INDEX. 






PAGE 




PAGE 


Syrupus — Continued. 




Thorn Apple . 
Thoroughwort 


. 226 


Sarsaparilla Composi- 




. 211 


tus 


247 


Thymacetin . 


• 305 


Scilla 


247 


Thymol . 


• 234 


Compositus . 88, 


247 


Thyroid Gland 


. 282 


Senegae 


l8l 


Tinctura 




Sennse 


195 


Aconiti 


. 164 






Aloes . 


. 248 


Tabacum 


229 


et Myrrha 


. 248 


Tables 




Ar niece 


. 212 


Apothecaries' Weight. 


l8 


Asafcetida . 


. 202 


Approximate Equiv. . 


19 


Belladonna Foliorum . 225 


Capacity . 


17 


Benzoini 


• 213 


Equivalents . 18, i 


9. 2 ° 


Composita 


. 214 


Length . . 


T 7 


Calumba . 


. 168 


Volume 


16 


Cannabis Indices 


. 242 


Weight 


16 


Capsici 


. 228 


Wine Measure . 


17 


Chloroformi et 


Mor- 


Tablets. 


12 


phinae 


• x 77 


Tasniacides . 


8 


Cimicifugce 


. 166 


Taka-diastase 


304 


Cinchona . 


• 203 


Tamar-Indien 


194 


Composita 


. 203 


Tamarinds 


J 93 


Colchici Seminis 


. 254 


Tannalbin 


3°5 


Digitalis 


• 232 


Tannic Acid . 


112 


Ferri Chloridi 


• 7° 


Glycerite of 


11 3 


Gelsemii 


. 216 


Ointment . 


113 


Gentiance Composita . 220 


Physiological Actions. 


112 


Hydrastis . 


. 167 


Preparations 


113 


Hyoscyami 


. 227 


Troches 


I1 3 


Iodi . 


. 08 


Tar . 


243 


Ipecacuanha et Opii . 176 


Ointment . 


243 


Lavandulae Composita 233 


Taraxacum . 


211 


Lobelia 


• 213 


Tartar Emetic . 86, 


271 


Nucis Vomica 


. 219 


Tartaric Acid 


112 


Opii 


. 175 


Tartrates . .36, 


112 


Camphorata . 


• i75 


Tea Plant 


209 


Composita 


. 176 


Terebenum . 


305 


Deodorata 


• i75 


Terpin Hydrate 


3o5 


Physostigmatis 


• 193 


Terpinol 


3°5 


Quassia 


. 188 


Tetanus 


218 


Rhei . 


• 234 


Antitoxin . 


279 


Scilla 


. 246 


Tetronal 


3o5 


Serpentaria 


. 236 


Thallein Acetate . 


3°5 


Stramonii . 


. 227 


Theocin 


30S 


Strophanthi 


. 221 


Thiersch Powder . 


1 5° 


Valeriana . 


. 210 


Thiophene 


IOI 


Ammoniata 


. 210 





INDEX. 


329 




PAGE 




PAGE 


Tinctura — Continued. 




Tragacantha . 


189 


Veratri 


251 


Trimet hy lamine 


3d 


Zingiber is . 


241 


Trinitrin 


142 


Tincturse 


9 


Trional . . . 


305 


Tincture of 




Trituratio Elaterini 


I99 


Aconite 


164 


Trochisci 


9 


Aloes . 


248 


Acidi Tannici . 


IJ 3 


and Myrrh 


248 


Tropical Fruit Laxative 


194 


Arnica 


212 


Tropococain . 
Tully's Powder 


306 


Asafcetida . 


202 


177 


Belladonna 


225 


Turpene 


196 


Benzoin 


213 


Tussol .... 


306 


Calumba 


168 






Cannabis Indica 


242 


Unguenta 


9 


Capsicum . 


228 


Unguentum 




Chloroform and Mor- 




Acidi Borici 


109 


phine 


177 


Acidi Tannici . 


Ix 3 


Cimicifuga 


166 


Diachylon . 


60 


Cinchona . 


203 


Hydrargyri 


80 


Colchicum Seeds 


254 


Hydrargyn Nitratis 


81 


Digitalis 


232 


Hydrargyri Oxidi Flavi 8 1 


Ferric Chloride . 


70 


Hydrargyri Oxidi R ubri 8 1 


Gelsemium 


2l6 


Iodi . 


98 


Ginger 


241 


Iodoformi . 


100 


Hydrastis . 


167 


Sulphuris . 


102 


Hyoscyamus 


227 


Veratrince . 


252 


Iodine 


98 


Zinci Oxidi 


65 


Ipecac and Opium 


176 


Urethan 


140 


Lavender . 


233 


Urinary, Acidifiers 


29 


Lobelia 


213 


Alkalinizers 


29 


Nux Vomica 


219 


Organs 


29 


Opium 


175 


Urotropin 


306 


Physostigmine . 


193 


Uterine Depressants 


30 


Quassia 


188 






Rhubarb 


234 


Vaccines . 277, 280 


, 281 


Serpentaria 


236 


Valerian 


209 


Squill 


. 246 


Vascular Sedatives 


22 


Stramonium 


227 


Vascular Stimulants 


22 


Strophanthus 


221 


Vaseline 


158 


Valerian . 


2IO 


Vegetable Cathartic Pills 


198 


Veratrum . 


. 251 


Vegetable Kingdom, 1 


161 


Tinctures . . 9, 1 


3. J S 


Veratrina 


251 


Tobacco 


229 


Veratrum 


250 


Toleration 


3 


Veronal 


306 


Toluene 


• 243 


Vescettes 


12 


Tonics . 


33 


Vesical Sedatives . 


30 


Tragacanth . 


. 189 


Vesicants 


3i 



33Q 


INDEX. 






PAGE 




PAGE 


Vesicating Collodion 


185 


Wine Measure 


18 


Vesicatories . 


3 1 


Wines . . 9, 10 


127 


Viburnum Opulus . 


202 


Wolfsbane 


161 


Viburnum Prunifolium 


202 


Wood Spirit . 


119 


Vinegars . . 9, ic 


, no 


Wool Fat 


260 


Vinum 








Album 
Antimonii . 
Colchici Seminis 
Ipecacuanha 
Portense . 


127 
88 

254 
207 
127 


Yellow Jessamine . 
Mercuric Oxide . 
Mercurous Iodide 
Wash 


215 
79 
79 
81 


Rubrum 


127 






Xericum . 


127 


Zinc i 


63 


Visceral Sedatives . 




Chloride 


64 






Ointment . 


65 


Warburg's Tincture 


206 


Physiological Actions. 


63 


Washed Sulphur . 


102 


Poisoning . 


63 


Waters 


9, 10 


Preparations 


64 


Whisky 


126 


Sulphate . 


64 


White Arsenic 


82 


Treatment of Poison- 




Whitewash . 


54 


ing . 


64 


White Wine . 


127 


Zinci 




Wild Cherry . 


195 


Chloridum 


64 


Wine of 




Oxidum 


65 


Antimony . 


88 


Sulphas . .64, 


271 


Colchicum Seed . 


2 54 


Zincum 


63 


Ipecac 


207 


Zingiber 


241 






Jl Selection from the 
Catalogue of 

G. P. PUTNAM'S SONS 



Complete Catalogues sent 
on application 



H GeyMBook for 
draining Scboote for Wuraes, 

By P. M. Wise, M.D., President of the New York State 
Lunacy Commission ; Medical Superintendent St. Law- 
rence State Hospital ; Editor of the State Hospitals 
Bulletin ; Professor of Psychiatry, University of Ver- 
mont ; Member of the American Medico-Psychological 
Association, etc. With an introduction by Dr. Edward 
Cowles, Physician-in-Chief and Superintendent McLean 
Hospital. 

Two volumes, i6°, illustrated, sold separately, 
each ........ net, $1.25 

This work will, it is believed, supply a present reed for training 
schools. It is distinctly a text-book for training schools as distin- 
guished from a text-book for nurses, and its arrangement provides 
tor all the recitations in a two years' course. The first volume is 
divided into thirty recitations or chapters, and includes anatomy, 
physiology, hygiene (and allied subjects — the atmosphere, ventila- 
tion, etc.), the sick-room, infection and disinfection, observation of 
symptoms, clinical recording, etc. Its arrangement is based upon a 
graded system of teaching ; the first volume being adapted for the 
first year's course. The second volume completes the course and 
provides for every subject usually taught by recitation in schools for 
nurses, leaving no requirement for auxiliary books. In fact the two 
volumes furnish completely all the requirements of the training 
school for a text-book. 

4 ' It is an admirable piece of work. It is written very clearly, and 
in language which can be very readily understood by the nurse. It 
covers the whole ground, and contains a great deal of matter not to 
be found in other books, and with the adoption of this book other 
text-books will not be required for the training school." — Dr. G 
Alder Blumer, Medical Superintendent of the Utica State Hospital. 

*' We believe this treatise will be adopted as a text-book in every 
training school in the country. Its excellency is such as to justify 
this belief, and surely training schools cannot afford to dispense with 
the best." — Buffalo Medical Journal. 



G. P. PUTNAM'S SONS, New York and London 



fPtftftts fox gltdiical jitttrtjenis. 



A Text-Book for Training Schools for Nurses. 

By P. M. Wise, M.D., President of the New York State 
Lunacy Commission ; Medical Superintendent St. Law- 
rence State Hospital ; Professor of Psychiatry, Univer- 
sity of Vermont, etc. With an introduction by Dr. 
Edward Cowles, Physician-in-Chief and Superintend- 
ent McLean Hospital. 

Second edition. Two volumes, illustrated, i6°, sold 
separately, each $!- 2 5 

" This text-book has been adopted by the ten State Hospitals of 
New York, representing approximately four hundred pupils." 

Dr. G. Alder Blumer (the medical superintendent of the Utica 
State Hospital) says : "It is an admirable piece of work. It is 
written very clearly, and in language which can be very readily 
understood by the nurse. It covers the whole ground, and contains 
a great deal of matter not to be found in other books, and with the 
adoption of this book other text-books will not be required for the 
training school." 

A Text=Book of Hateria Hedica for Nurses. 

Compiled by Lavinia L. Dock, graduate of Bellevue 
Training School for Nurses, late superintendent of 
nurses, Illinois Training School for Nurses, etc. 

Fourth edition, revised and enlarged. Fortieth thou- 
sand. 12° net, $i.$o 

" The work is interesting, valuable, and worthy a position in any 
library." — N. Y. Medical Record. 

" It is written very concisely, and little can be found in it to criti- 
cise unfavorably, except the inevitable danger that the student will 
imagine after reading it that the whole subject has been mastered. 
The subject of therapeutics has been omitted as not a part of a 
nurse's study, and this omission is highly to be commended. It will 
prove a valuable book for the purpose for which it is intended." — 
N. Y. Medical Journal. 

Medical and Surgical Nursing. 

A Treatise on Modern Nursing from the Physician's and 
Surgeon's Standpoint, for the Guidance of Graduate and 
Student Nurses, together with Practical Instruction in 
the Art of Cooking for the Sick. By H. J. O'Brien, 
M.D. 12° net, $1.50 






G. P. PUTNAM'S SONS, New York and London 



NOV 4 1 



LIBRARY OF CONGRESS 



DDDEL10D43H 



